Surgical suturing instrument comprising a capture width which is larger than trocar diameter

ABSTRACT

A surgical suturing system is disclosed. The surgical suturing system comprises a firing drive, an end effector, and a needle configured to be driven by said firing drive. The end effector comprises a track defined therein configured to guide the needle through a needle firing stroke. The surgical suturing system further comprises a needle driver configured to be driven by the firing drive and configured to drive the needle through the needle firing stroke.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 62/578,793,entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filed Oct. 30, 2017,of U.S. Provisional Patent Application Ser. No. 62/578,804, entitledSURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENTTYPES OF END EFFECTOR MOVEMENT, filed Oct. 30, 2017, of U.S. ProvisionalPatent Application Ser. No. 62/578,817, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No.62/578,835, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Oct. 30, 2017, of U.S.Provisional Patent Application Ser. No. 62/578,844, entitled SURGICALINSTRUMENT WITH MODULAR POWER SOURCES, filed Oct. 30, 2017, and of U.S.Provisional Patent Application Ser. No. 62/578,855, entitled SURGICALINSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed Oct. 30, 2017, thedisclosures of which are incorporated by reference herein in theirentirety. This non-provisional application claims the benefit under 35U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No.62/665,129, entitled SURGICAL SUTURING SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,139, entitledSURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,177, entitledSURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS, filed May 1, 2018,of U.S. Provisional Patent Application Ser. No. 62/665,128, entitledMODULAR SURGICAL INSTRUMENTS, filed May 1, 2018, of U.S. ProvisionalPatent Application Ser. No. 62/665,192, entitled SURGICAL DISSECTORS,filed May 1, 2018, and of U.S. Provisional Patent Application Ser. No.62/665,134, entitled SURGICAL CLIP APPLIER, filed May 1, 2018, thedisclosures of which are incorporated by reference herein in theirentirety.

BACKGROUND

The present disclosure relates to surgical systems and, in variousarrangements, to grasping instruments that are designed to grasp thetissue of a patient, dissecting instruments configured to manipulate thetissue of a patient, clip appliers configured to clip the tissue of apatient, and suturing instruments configured to suture the tissue of apatient, among others.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is a perspective view of a surgical suturing instrumentcomprising a handle, a shaft, and an end effector;

FIG. 2 is a partial plan view of the surgical suturing instrument ofFIG. 1 ;

FIG. 3 is a partial plan view of the surgical suturing instrument ofFIG. 1 , wherein the end effector is in an articulated state;

FIG. 4 is a partial perspective view of the surgical suturing instrumentof FIG. 1 ;

FIG. 5 is a partial perspective view of the surgical suturing instrumentof FIG. 1 , wherein the end effector is in an articulated and rotatedstate;

FIG. 6 is a schematic of a needle sensing system and a circuit diagramof a needle sensing circuit of the needle sensing system, wherein aneedle of the needle sensing system is in a home position;

FIG. 7 is a schematic of the needle sensing system of FIG. 6 and acircuit diagram of the needle sensing circuit of FIG. 6 , wherein theneedle is in a first partially fired position;

FIG. 8 is a schematic of the needle sensing system of FIG. 6 and acircuit diagram of the needle sensing circuit of FIG. 6 , wherein theneedle is in a second partially fired position;

FIG. 9 is a logic diagram of a process depicting a control program forcontrolling a surgical suturing instrument;

FIG. 10 is a plan view of a suturing device cartridge comprising anadaptive needle driving system;

FIG. 11 is a graph of a first aspect of an adaptive needle drivingsystem;

FIG. 12 is a graph of a second aspect of the adaptive needle drivingsystem of FIG. 11 ;

FIG. 13 is a graph of a third aspect of the adaptive needle drivingsystem of FIG. 11 ;

FIG. 14 is a plan view of a collapsible suturing device comprising ashaft and a needle driving system, wherein the needle driving systemcomprises a movable needle guide, and wherein the movable needle guideis in an expanded position;

FIG. 15 is a plan view of the suturing device of FIG. 14 , wherein themovable needle guide is in a collapsed position;

FIG. 16 is a plan view of the suturing device of FIG. 14 , wherein themovable needle guide is in a partially expanded position;

FIG. 17 is a plan view of a collapsible suturing device comprising ashaft and an end effector configured to be articulated relative to theshaft, wherein the end effector comprises a needle driving systemcomprising a movable needle guide;

FIG. 18 is a plan view of a collapsible suturing device comprising aneedle driving system comprising a movable needle guide and anintermediate feed wheel;

FIG. 19 is a cross-sectional view of an end effector of a suturingdevice comprising a body portion, a needle track defined within the bodyportion, and a suturing needle, wherein the suturing needle is in aparked position;

FIG. 20 is a cross-sectional view of the end effector of FIG. 19 ,wherein the suturing needle is in a ready-to-fire position;

FIG. 21 is a cross-sectional view of the end effector of FIG. 19 ,wherein the suturing needle is in a partially-fired position;

FIG. 22 is a diagram illustrating a relationship between stress andstrain of a component of an end effector and corresponding identifiableevents during the use of the end effector;

FIG. 23 is a partial perspective view of a surgical instrument systemcomprising an actuation interface and a modular shaft to be actuatedwith the actuation interface, wherein the surgical instrument system isshown in a partially attached configuration;

FIG. 24 is a graph illustrating a sensed torque of the surgicalinstrument system of FIG. 23 and a sensed current of a motor of thesurgical instrument system of FIG. 23 ;

FIG. 25 is a partial perspective view of a surgical grasper and amono-polar bridge instrument;

FIG. 26 is a graph illustrating a reactive algorithm of the surgicalgrasper of FIG. 25 ;

FIG. 27 is a logic diagram of a process depicting a control program forcontrolling a surgical instrument;

FIG. 28 is a partial perspective view of a surgical suturing instrument;and

FIG. 29 is a graph depicting sensed parameters of the surgical suturinginstrument of FIG. 28 and also depicting an algorithm for the surgicalsuturing instrument to react to the sensed parameters.

FIG. 30 is a logic diagram of a process depicting a control program forcontrolling a surgical suturing instrument;

FIG. 31 is a perspective view of an end effector assembly comprising asuture cartridge;

FIG. 32 is a partial perspective view of the end effector assembly ofFIG. 31 ;

FIG. 33 is a partial cross-sectional view of an end effector assemblycomprising a needle sensing system;

FIG. 34 is a partial perspective view of an end effector assemblycomprising a needle sensing system;

FIG. 35 is a partial perspective view of an end effector assemblycomprising a needle sensing system;

FIG. 36 is a partial perspective view of an end effector assemblycomprising a needle sensing system;

FIG. 37 is a partial perspective view of an end effector assemblycomprising a needle sensing system;

FIG. 38 is a perspective view of a helical suturing needle for use witha surgical suturing instrument;

FIG. 39 is an elevational view of the helical suturing needle of FIG. 38;

FIG. 40 is a logic flow diagram of a process depicting a control programfor controlling a surgical instrument;

FIG. 41 is a perspective view of a surgical suturing instrument handlecomprising a motor;

FIG. 42 is a partial cross-sectional view of the surgical suturinginstrument handle of FIG. 41 ;

FIG. 43 is an exploded view of a suturing cartridge for use with asurgical suturing system;

FIG. 44 is a partial cross-sectional view of a surgical instrumentincluding a jaw assembly capable of grasping and dissection inaccordance with at least one embodiment;

FIG. 45 is a graph depicting the force, speed, and orientation of thejaw assembly of FIG. 44 in accordance with at least one embodiment;

FIG. 46 is a partial perspective view of bipolar forceps being used tocut tissue;

FIG. 47 is a perspective view of the bipolar forceps of FIG. 46 ;

FIG. 48 is a graph depicting the force and speed of the jaws of thebipolar forceps of FIG. 46 in accordance with at least one embodiment;

FIG. 49 is another graph depicting the operation of the bipolar forcepsof FIG. 46 in accordance with at least one embodiment; and

FIG. 50 is a schematic of a control system for use with any of thesurgical instruments disclosed herein.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. patentapplications that were filed on Aug. 24, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/112,129, entitled SURGICAL        SUTURING INSTRUMENT CONFIGURED TO MANIPULATE TISSUE USING        MECHANICAL AND ELECTRICAL POWER, now U.S. Patent Application        Publication No. 2019/0125431;    -   U.S. patent application Ser. No. 16/112,168, entitled SURGICAL        SUTURING INSTRUMENT COMPRISING A NON-CIRCULAR NEEDLE, now U.S.        Patent Application Publication No. 2019/0125336;    -   U.S. patent application Ser. No. 16/112,180, entitled ELECTRICAL        POWER OUTPUT CONTROL BASED ON MECHANICAL FORCES, now U.S. Patent        Application Publication No. 2019/0125432;    -   U.S. patent application Ser. No. 16/112,193, entitled REACTIVE        ALGORITHM FOR SURGICAL SYSTEM, now U.S. Pat. No. 10,932,806;    -   U.S. patent application Ser. No. 16/112,099, entitled SURGICAL        INSTRUMENT COMPRISING AN ADAPTIVE ELECTRICAL SYSTEM, now U.S.        Patent Application Publication No. 2019/012538;    -   U.S. patent application Ser. No. 16/112,112, entitled CONTROL        SYSTEM ARRANGEMENTS FOR A MODULAR SURGICAL INSTRUMENT, now U.S.        Patent Application Publication No. 2019/0125320;    -   U.S. patent application Ser. No. 16/112,119, entitled ADAPTIVE        CONTROL PROGRAMS FOR A SURGICAL SYSTEM COMPRISING MORE THAN ONE        TYPE OF CARTRIDGE, now U.S. Patent Application Publication No.        2019/0125338;    -   U.S. patent application Ser. No. 16/112,097, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING BATTERY ARRANGEMENTS, now U.S.        Patent Application Publication No. 2019/0125377;    -   U.S. patent application Ser. No. 16/112,109, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING HANDLE ARRANGEMENTS, now U.S.        Patent Application Publication No. 2019/0125388;    -   U.S. patent application Ser. No. 16/112,114, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING FEEDBACK MECHANISMS, now U.S. Pat.        No. 10,980,560;    -   U.S. patent application Ser. No. 16/112,117, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING LOCKOUT MECHANISMS, now U.S.        Patent Application Publication No. 2019/0125476;    -   U.S. patent application Ser. No. 16/112,095, entitled SURGICAL        INSTRUMENTS COMPRISING A LOCKABLE END EFFECTOR SOCKET, now U.S.        Pat. No. 11,291,465;    -   U.S. patent application Ser. No. 16/112,121, entitled SURGICAL        INSTRUMENTS COMPRISING A SHIFTING MECHANISM, now U.S. Pat. No.        11,026,712;    -   U.S. patent application Ser. No. 16/112,151, entitled SURGICAL        INSTRUMENTS COMPRISING A SYSTEM FOR ARTICULATION AND ROTATION        COMPENSATION, now U.S. Pat. No. 10,772,651;    -   U.S. patent application Ser. No. 16/112,154, entitled SURGICAL        INSTRUMENTS COMPRISING A BIASED SHIFTING MECHANISM, now U.S.        Pat. No. 11,207,090;    -   U.S. patent application Ser. No. 16/112,226, entitled SURGICAL        INSTRUMENTS COMPRISING AN ARTICULATION DRIVE THAT PROVIDES FOR        HIGH ARTICULATION ANGLES, now U.S. Pat. No. 11,129,636;    -   U.S. patent application Ser. No. 16/112,062, entitled SURGICAL        DISSECTORS AND MANUFACTURING TECHNIQUES; now U.S. Pat. No.        10,959,744;    -   U.S. patent application Ser. No. 16/112,098, entitled SURGICAL        DISSECTORS CONFIGURED TO APPLY MECHANICAL AND ELECTRICAL ENERGY,        now U.S. Patent Application Publication No. 2019/0125430;    -   U.S. patent application Ser. No. 16/112,237, entitled SURGICAL        CLIP APPLIER CONFIGURED TO STORE CLIPS IN A STORED STATE, now        U.S. Pat. No. 11,026,713;    -   U.S. patent application Ser. No. 16/112,245, entitled SURGICAL        CLIP APPLIER COMPRISING AN EMPTY CLIP CARTRIDGE LOCKOUT, now        U.S. Pat. No. 11,051,836;    -   U.S. patent application Ser. No. 16/112,249, entitled SURGICAL        CLIP APPLIER COMPRISING AN AUTOMATIC CLIP FEEDING SYSTEM, now        U.S. Pat. No. 11,109,878;    -   U.S. patent application Ser. No. 16/112,253, entitled SURGICAL        CLIP APPLIER COMPRISING ADAPTIVE FIRING CONTROL, now U.S. Pat.        No. 11,103,268; and    -   U.S. patent application Ser. No. 16/112,257, entitled SURGICAL        CLIP APPLIER COMPRISING ADAPTIVE CONTROL IN RESPONSE TO A STRAIN        GAUGE CIRCUIT, now U.S. Pat. No. 11,071,260;

Applicant of the present application owns the following U.S. patentapplications that were filed on May 1, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Provisional Patent Application Ser. No. 62/665,129,        entitled SURGICAL SUTURING SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/665,139,        entitled SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/665,177,        entitled SURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS;    -   U.S. Provisional Patent Application Ser. No. 62/665,128,        entitled MODULAR SURGICAL INSTRUMENTS;    -   U.S. Provisional Patent Application Ser. No. 62/665,192,        entitled SURGICAL DISSECTORS; and    -   U.S. Provisional Patent Application Ser. No. 62/665,134,        entitled SURGICAL CLIP APPLIER.

Applicant of the present application owns the following U.S. patentapplications that were filed on Feb. 28, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 15/908,021, entitled SURGICAL        INSTRUMENT WITH REMOTE RELEASE;    -   U.S. patent application Ser. No. 15/908,012, entitled SURGICAL        INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT        TYPES OF END EFFECTOR MOVEMENT;    -   U.S. patent application Ser. No. 15/908,040, entitled SURGICAL        INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END        EFFECTOR FUNCTIONS;    -   U.S. patent application Ser. No. 15/908,057, entitled SURGICAL        INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END        EFFECTOR FUNCTIONS;    -   U.S. patent application Ser. No. 15/908,058, entitled SURGICAL        INSTRUMENT WITH MODULAR POWER SOURCES; and    -   U.S. patent application Ser. No. 15/908,143, entitled SURGICAL        INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. patentapplications that were filed on Oct. 30, 2017 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Provisional Patent Application Ser. No. 62/578,793,        entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE;    -   U.S. Provisional Patent Application Ser. No. 62/578,804,        entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO        EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT;    -   U.S. Provisional Patent Application Ser. No. 62/578,817,        entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY        ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;    -   U.S. Provisional Patent Application Ser. No. 62/578,835,        entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY        ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;    -   U.S. Provisional Patent Application Ser. No. 62/578,844,        entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES; and    -   U.S. Provisional Patent Application Ser. No. 62/578,855,        entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Dec. 28, 2017, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/611,341,        entitled INTERACTIVE SURGICAL PLATFORM;    -   U.S. Provisional Patent Application Ser. No. 62/611,340,        entitled CLOUD-BASED MEDICAL ANALYTICS; and    -   U.S. Provisional Patent Application Ser. No. 62/611,339,        entitled ROBOT ASSISTED SURGICAL PLATFORM.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 28, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302,        entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED        COMMUNICATION CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294,        entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS        AND CREATE ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300,        entitled SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309,        entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN        OPERATING THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310,        entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291,        entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO        DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296,        entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND        AUTHENTICATION TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315,        entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS        NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313,        entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320,        entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307,        entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323,        entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,641, entitled        INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION        CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,648, entitled        INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES        AND DATA CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,656, entitled SURGICAL        HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM        DEVICES;    -   U.S. patent application Ser. No. 15/940,666, entitled SPATIAL        AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;    -   U.S. patent application Ser. No. 15/940,670, entitled        COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES        BY INTELLIGENT SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,677, entitled SURGICAL        HUB CONTROL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/940,632, entitled DATA        STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. patent application Ser. No. 15/940,640, entitled        COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND        STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED        ANALYTICS SYSTEMS;    -   U.S. patent application Ser. No. 15/940,645, entitled SELF        DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;    -   U.S. patent application Ser. No. 15/940,649, entitled DATA        PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN        OUTCOME;    -   U.S. patent application Ser. No. 15/940,654, entitled SURGICAL        HUB SITUATIONAL AWARENESS;    -   U.S. patent application Ser. No. 15/940,663, entitled SURGICAL        SYSTEM DISTRIBUTED PROCESSING;    -   U.S. patent application Ser. No. 15/940,668, entitled        AGGREGATION AND REPORTING OF SURGICAL HUB DATA;    -   U.S. patent application Ser. No. 15/940,671, entitled SURGICAL        HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;    -   U.S. patent application Ser. No. 15/940,686, entitled DISPLAY OF        ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;    -   U.S. patent application Ser. No. 15/940,700, entitled STERILE        FIELD INTERACTIVE CONTROL DISPLAYS;    -   U.S. patent application Ser. No. 15/940,629, entitled COMPUTER        IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. patent application Ser. No. 15/940,704, entitled USE OF        LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE        PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. patent application Ser. No. 15/940,722, entitled        CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF        MONO-CHROMATIC LIGHT REFRACTIVITY; and    -   U.S. patent application Ser. No. 15/940,742, entitled DUAL CMOS        ARRAY IMAGING.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,636, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,660, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. patent application Ser. No. 15/940,679, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS        WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;    -   U.S. patent application Ser. No. 15/940,694, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED        INDIVIDUALIZATION OF INSTRUMENT FUNCTION;    -   U.S. patent application Ser. No. 15/940,634, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION        TRENDS AND REACTIVE MEASURES;    -   U.S. patent application Ser. No. 15/940,706, entitled DATA        HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and    -   U.S. patent application Ser. No. 15/940,675, entitled CLOUD        INTERFACE FOR COUPLED SURGICAL DEVICES.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,627, entitled DRIVE        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,637, entitled        COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,642, entitled CONTROLS        FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC        TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,680, entitled        CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,683, entitled        COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,690, entitled DISPLAY        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and    -   U.S. patent application Ser. No. 15/940,711, entitled SENSING        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 30, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/650,887,        entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/650,877,        entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS;    -   U.S. Provisional Patent Application Ser. No. 62/650,882,        entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL        PLATFORM; and    -   U.S. Provisional Patent Application Ser. No. 62/650,898,        entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY        ELEMENTS.

Applicant of the present application owns the following U.S. Provisionalpatent application, filed on Apr. 19, 2018, which is herein incorporatedby reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/659,900,        entitled METHOD OF HUB COMMUNICATION.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”), and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes”, or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes”, or “contains” one or more features possesses thoseone or more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

The embodiments disclosed herein are configured for use with surgicalsuturing instruments and systems such as those disclosed in U.S. patentapplication Ser. No. 13/832,786, now U.S. Pat. No. 9,398,905, entitledCIRCULAR NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS; U.S.patent application Ser. No. 14/721,244, now U.S. Patent ApplicationPublication No. 2016/0345958, entitled SURGICAL NEEDLE WITH RECESSEDFEATURES; and U.S. patent application Ser. No. 14/740,724, now U.S.Patent Application Publication No. 2016/0367243, entitled SUTURINGINSTRUMENT WITH MOTORIZED NEEDLE DRIVE, which are incorporated byreference in their entireties herein. The embodiments discussed hereinare also usable with the instruments, systems, and methods disclosed inU.S. patent application Ser. No. 15/908,021, entitled SURGICALINSTRUMENT WITH REMOTE RELEASE, filed on Feb. 28, 2018, U.S. patentapplication Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVINGDUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTORMOVEMENT, filed on Feb. 28, 2018, U.S. patent application Ser. No.15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S.patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,058,entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed on Feb.28, 2018, and U.S. patent application Ser. No. 15/908,143, entitledSURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed on Feb.28, 2018, which are incorporated in their entireties herein. Theembodiments discussed herein are also usable with the instruments,systems, and methods disclosed in U.S. Provisional Patent ApplicationNo. 62/659,900, entitled METHOD OF HUB COMMUNICATION, filed on Apr. 19,2018, U.S. Provisional Patent Application No. 62/611,341, entitledINTERACTIVE SURGICAL PLATFORM, filed on Dec. 28, 2017, U.S. ProvisionalPatent Application No. 62/611,340, entitled CLOUD-BASED MEDICALANALYTICS, filed on Dec. 28, 2017, and U.S. Provisional PatentApplication No. 62/611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM,filed on Dec. 28, 2017, which are incorporated by reference in theirentireties herein. Generally, these surgical suturing instrumentscomprise, among other things, a shaft, an end effector attached to theshaft, and drive systems positioned within the shaft to transfer motionfrom a source motion to the end effector. The motion source can comprisea manually driven actuator, an electric motor, and/or a robotic surgicalsystem. The end effector comprises a body portion, a needle trackdefined within the body portion, and a needle driver configured to drivea needle through a rotational firing stroke. The needle is configured tobe guided through its rotational firing stroke within the body portionby the needle track. In various instances, the needle driver is similarto that of a ratchet system. In at least one instance, the needle driveris configured to drive the needle through a first half of the rotationalfiring stroke which places the needle in a hand-off position—a positionwhere a tissue-puncturing end of the needle has passed through thetarget tissue and reentered the body portion of the end effector. Atsuch point, the needle driver can be returned to its original positionto pick up the tissue-puncturing end of the needle and drive the needlethrough a second half of its rotational firing stroke. Once the needledriver pulls the needle through the second half of its rotational firingstroke, the needle driver is then returned to its original unfiredposition to grab the needle for another rotational firing stroke. Thedrive systems can be driven by one or more motors and/or manual driveactuation systems. The needle comprises suturing material, such asthread, for example, attached thereto. The suturing material isconfigured to be pulled through tissue as the needle is advanced throughits rotational firing stroke to seal the tissue and/or attached thetissue to another structure, for example.

FIGS. 1-5 depict a surgical suturing instrument 94000 configured tosuture the tissue of a patient. The surgical suturing instrument 94000comprises a handle 94100, a shaft 94200 extending distally from thehandle 94100, and an end effector 94300 attached to the shaft 94200 byway of an articulation joint 94210. The handle 94100 comprises a firingtrigger 94110 configured to actuate a firing drive of the surgicalsuturing instrument 94000, a first rotational actuator 94120 configuredto articulate the end effector 94300 about an articulation axis AAdefined by the articulation joint 94210, and a second rotationalactuator 94130 configured to rotate the end effector 94300 about alongitudinal axis LA defined by the end effector 94300. The surgicalsuturing instrument 94000 further comprises a flush port 94140. Examplesof surgical suturing devices, systems, and methods are disclosed in U.S.patent application Ser. No. 13/832,786, now U.S. Pat. No. 9,398,905,entitled CIRCULAR NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS;U.S. patent application Ser. No. 14/721,244, now U.S. Patent ApplicationPublication No. 2016/0345958, entitled SURGICAL NEEDLE WITH RECESSEDFEATURES; and U.S. patent application Ser. No. 14/740,724, now U.S.Patent Application Publication No. 2016/0367243, entitled SUTURINGINSTRUMENT WITH MOTORIZED NEEDLE DRIVE, which are incorporated byreference in their entireties herein.

FIGS. 6-8 depict a needle sensing system 91000 configured to be usedwith a surgical suturing instrument system. The needle sensing system91000 comprises a resistive sensing circuit configured to allow acontrol program of a control interface to determine the position of aneedle during its firing stroke by monitoring the resistance of theresistive sensing circuit. The needle sensing system 91000 comprises aneedle sensing circuit 91100 and a needle 91200. The needle sensingcircuit 91100 comprises a supply portion, or leg, 91110 terminating at afirst terminal 91112 and comprising a first resistance R1. The needlesensing circuit 91100 further comprises a return portion 91120comprising a first return leg 91130 terminating at a first returnterminal 91132 and a second return leg 91140 terminating a second returnterminal 91142. The first return leg 91130 and the second return leg91140 are wired in parallel with respect to each other. The first returnleg 91130 comprises a second resistance R2 and the second return leg91140 comprises a third resistance R3. Discussed in greater detailbelow, the needle 91210 is configured to act as a switch for the needlesensing circuit 91100 by contacting the terminals 91112, 91132, and91142 during its firing stroke as the needle 91200 moves in a rotationaldirection to suture tissue. The resistance of such a circuit can bemonitored by a processor to determine the location of the needle 91200during its firing stroke.

The needle 91200 comprises a tip 91213, a butt end 91211, and an arcuateshaft 91212 extending between the tip 91213 and the butt end 91211. Theneedle 91200 further comprises suturing material 91220 attached to thebutt end 91211 of the needle 91200. The tip 91213 comprises a bevel, orpoint, 91215 configured to pierce tissue during a firing stroke of theneedle 91200. As the needle 91200 moves through its firing stroke, it isconfigured to move into and out of contact with the terminals 91112,91132, and 91142. In its starting, or home, position (FIG. 6 ), theneedle 91200 is in contact with all three terminals 91112, 91132, and91142. The total resistance of the circuit 91100 in this configurationcan be detected by the control system of the suturing instrument toidentify that the needle 91200 is in its starting position. The totalresistance of the circuit 91100 in this configuration is shown in thecircuit diagram 91000′ of FIG. 6 and can be referred to as the startingposition resistance. Once the needle 91200 is advanced out of itsstarting position and the butt end 91211 of the needle 91200 moves outof contact with the terminal 91112, the needle 91200 has been partiallyfired and is now only in contact with two terminals 91132, 91142 (FIG. 7). The total resistance of the circuit 91100 in this configuration canbe detected by the control system to identify that the needle 91200 isin a first partially-fired position. The total resistance of the circuit91100 in this configuration is shown in the circuit diagram 91000′ ofFIG. 7 and can be referred to as the first partially-fired positionresistance. Once the needle 91200 is advanced out of contact with thesecond terminal 91132 and back into contact with the first terminal91112, the circuit 91100 now comprises a third total resistance that isdifferent from the starting position resistance and the first-partiallyfired position resistance. This can be referred to as the secondpartially-fired position resistance (FIG. 8 ). Because the secondpartially-fired position resistance is different than the startingposition resistance and the first partially-fired position resistance,the second partially-fired position resistance can be detected todetermine that the needle 91200 has moved into the secondpartially-fired position.

The system 91100 permits the needle location to be detected directly.Monitoring the needle location over a period of time can provide meansfor determining the rate of advancement of the needle and/or changes inrate of advancement of the needle during its firing stroke. In variousinstances, if the needle is sensed to be moving at a rate slower thanpreferred, for example, the instrument can automatically adjust a powercontrol program of the motor which is advancing the needle through itsfiring stroke to speed up the needle. Similarly, if the needle is sensedto be moving at a rate faster than preferred, for example, theinstrument can automatically adjust the power control program of themotor which is advancing the needle through its firing stroke to slowdown the needle. This arrangement allows the control program to adaptthe rate and/or sequence at which the needle is fired during a procedureand/or during each firing stroke of the needle to better accommodatevariable conditions such as, for example, variable tissue thicknessesduring suturing.

FIG. 9 illustrates a logic flow diagram of a process 93800 depicting acontrol program for controlling a surgical suturing instrument. Theprocess 93800 comprises monitoring 93801 a position sensing circuitoutput. For example, the output resistance of the system 91110 can bemonitored throughout the operation of a surgical suturing instrument.The process 93800 further includes determining 93803 if the controlmotions applied to the needle need to be adjusted based on the positionsensing circuit output. A processor, for example, can monitor theposition sensing circuit output over a period of time and calculate thespeed of the needle during its firing stroke. If the speed is too fastor too slow for the present tissue thickness, for example, the controlprogram can adjust 93807 the control motions applied to the needle tochange the speed of the needle firing stroke. If the speed of the needleis consistent with a predetermined speed profile for the present tissuethickness, the control program can continue 93805 normal operation ofthe instrument. Other position sensing systems disclosed herein can beused with this process.

FIG. 10 depicts a needle sensing system 91300 configured to allow acontrol system of a suturing instrument to monitor the motions of theneedle within the end effector against the anticipated, or expected,motions of the needle. In various instances, backlash in a motor-drivenneedle drive system, for example, could cause the drive system toproduce a shorter needle stroke than expected for a given amount ofmotor rotations. The needle sensing system 91300 comprises an endeffector 91310, a needle track 91312 defined within the end effector91310, and a needle 91320. Similar to the above, the needle 91320 isconfigured to be actuated by a needle driver to move the needle 91320through a circular firing stroke. The needle 91320 is guided by theneedle track 91312 as the needle 91320 is actuated by the needle driver.The needle sensing system 91300 comprises a plurality of sensors 91340designated as 51, S2, S3, and S4 which, as discussed below, areconfigured to track the motion of the needle 91320. The sensors 91340may be any suitable position-detecting sensor such that, as the needle91320 engages, or trips, a sensor 91340, that sensor sends a voltagesignal to the control system that the sensor 91340 has detected that theneedle 91320 indicating the position of the needle 91320. The needle91320 comprises a tip 91322 that is configured to initially trip thesensors 91340 as the tip 91322 approaches and contacts, or otherwisetrips, the sensors 91340. The end effector 91310 further comprises atissue opening 91314 defined therein. In use, the end effector 91310 ispressed against the patient tissue such that the tissue enters theopening 91314. At such point, the tip 91322 can pierce tissue in theopening 91314 and then re-enter the needle track 91312 on the other sideof the end effector 91310. The needle 91320 is dimensioned to have alarger length than the distance of the opening 91314 so that the needle91320 can be guided by the needle track 91312 back into the needle track91312 before a butt end of the needle exits the end effector 91310 intothe opening 91314.

FIG. 11 is a graph 91350 depicting a portion of a needle firing strokeusing the needle sensing system 91300 of FIG. 10 . As can be seen in thegraph 91350 illustrated in FIG. 11 , there is an overlap of detectionfor each neighboring sensor. During a needle firing stroke, each sensoris configured to detect the tip 91322 of the needle 91320 before theprevious sensor no longer detects the needle 91320. In anotherembodiment, more than two sensors are configured to sense the needleduring the needle firing stroke.

The sensors 91340 can be used in combination with a control program toensure that a motor driving the needle 91320 through its firing strokeis driving the needle 91320 the expected amount. For example, a certainamount of rotation from the needle drive motor should produce acorresponding travel length of the needle 91320. Monitoring the positionof the needle 91320 in the end effector 91310 along with rotationalmotion of the motor can provide a way to make sure that the motor isproducing the anticipated drive motions of the needle. An example of aneedle stroke where the rotational motion of the motor and the actuallength of needle travel are monitored is depicted in the graph 91360illustrated in FIG. 12 . If the motion of the needle is not asanticipated, the control system can adjust the power delivered to themotor to account for these differences and assure that the needle isbeing driven all the way around its firing path during a firing stroke.For example, if the motor takes more rotations than expected to causethe needle to travel a certain distance, the control system can increasethe number of rotations for the needle to complete the firing stroke.Such instances could be due to backlash in the drive system, forexample.

If the actual motions sensed by a needle position sensing system are notas expected, the control program can place the system in a limp mode,for example, to prevent premature failure of components.

The needle sensing system 91300 can also monitor the current drawn bythe needle drive motor while monitoring the input from the sensors91340. In such an embodiment, a control program can the reverseactuation of the needle 91320 in the event that a substantial increasein current is detected in the motor and the subsequent sensor 91340 hasnot been tripped—possibly indicating that the needle is jammed. In thesame and/or another embodiment, an encoder can be used to measure thenumber of rotations being provided by the motor. A control program cancompare the number of rotations being provided by the motor to the inputfrom the sensors 91340. In an instance where the sensors 91340 are notbeing tripped as expected by a given amount of rotation from the motor,the control program can interrogate the motor current to assess why theneedle is not traveling the expected distance. If the motor current issubstantially high, this could indicate a jam, as discussed above. Ifthe motor current is substantially low, this could indicate that theneedle and the needle driver are no longer coupled, for example, andthat the needle driver is freely moving without driving the needle. Inan alternative embodiment, motor torque can be sensed instead of motorcurrent. An example of current monitoring can be seen in the graph 91370illustrated in FIG. 13 .

FIGS. 14-16 depict a surgical suturing instrument 91500 comprising ashaft 91510, an end effector 91530, and a needle drive system 91550. Thesurgical suturing instrument 91500 is designed to provide a suturingbite width that is larger than the diameter of the shaft 91510 by usingan expandable/collapsible needle guide element. Various suturing devicesare limited to a bite width that is constrained by the diameter of theirshafts. The surgical suturing instrument 91500 comprises a movableneedle guide 91560 rotatably mounted to a body 91540 of the end effector91530 configured to permit the use of a needle 91570, which alsocomprises a length that exceeds the width of the shaft diameter. Toactuate the movable needle guide 91560, a linear actuator 91512connected to a proximal end 91562 of the movable needle guide 91560 isconfigured to be pushed and pulled to pivot the movable needle guide91560 about its pivot point 91562. FIG. 14 illustrates the movableneedle guide 91560 in an expanded configuration where the surgicalsuturing instrument 91500 is ready to be fired. To pivot the movableneedle guide 91560 into its closed configuration (FIG. 15 ), the linearactuator 91512 is pulled proximally. When the movable needle guide 91560is in its closed configuration, the surgical suturing instrument 91500is in a configuration sufficient to be passed through a trocar.

The needle drive system 91550 comprises a linear actuator 91520, aproximal needle feed wheel 91552 configured to be rotated about itspivot 91552 by way of the linear actuator 91520 and rotatably mountedwithin the body 91540 of the end effector 91530, and a distal needlefeed wheel 91554 configured to be rotated about its pivot 91555 by aconnecting link 91556 by way of the proximal needle feed wheel 91552 androtatably mounted within the body 91540 of the end effector 91530. Thefeed wheels 91552, 91554 are configured to be rotated together to movethe flexible needle 91570 through the body 91540 of the end effector91530 and out of the body 91540 of the end effector 91530 against themovable needle guide 91560. The movable needle guide 91560 comprises acurved tip 91563 configured to guide the flexible needle 91570 back intothe body 91540 of the end effector 91530 so that the distal needle feedwheel 91554 can begin guiding the flexible needle 91570 back toward theproximal needle feed wheel 91552. The feed wheels 91552, 91554 areconnected by a coupler bar such that they rotate at the same time.

In various instances, the needle 91570 may need to be repaired orreplaced. To remove the needle 91570 from the end effector 91530, themovable needle guide 91560 may be pivoted outwardly to provide access tothe needle 91570 (FIG. 16 ).

The needle 91570 comprises an arc length A. The distance between thepivots 91553, 91555 of the feed wheels 91552, 91554 is labeled length B.The arc length A of the needle 91570 must be greater than the length Bin order to be able to guide the flexible needle 91570 back into the endeffector body 91540 with the proximal needle feed wheel 91553. Such anarrangement allows a capture, or bite, width 91580 of the surgicalsuturing instrument 91500 to be larger than the diameter of the shaft91510. In certain instances, a portion of the end effector containingthe needle drive system 91550 can be articulated relative to the endeffector body 91540 so that the capture width, or opening, 91580 canhinge outwardly and face tissue distally with respect to the instrument91500. This arrangement can prevent a user from having to preform thesuturing procedure with respect to the side of the instrument 91500.Such a feature may utilize a hinge mechanism with snap features torigidly hold the end effector body 91540 in a firing position as opposedto a position suitable for insertion through a trocar.

As outlined above, a portion of the end effector 91530 is movable toincrease or decrease the width of the end effector 91530. Decreasing thewidth of the end effector 91530 allows the end effector 91530 to beinserted through a narrow trocar passageway. Increasing the width of theend effector 91530 after it has been passed through the trocar allowsthe end effector 91530 to make larger suture loops in the patienttissue, for example. In various instances, the end effector 91530 and/orthe needle 91570 can be flexible so that they can be compressed as theyare inserted through the trocar and then re-expand once they have passedthrough the trocar. Such an arrangement, as described above, allows alarger end effector to be used.

FIG. 17 depicts a collapsible suturing device 92300 comprising a shaft92310 and an end effector 92320 configured to be articulated relative tothe shaft 92310. The device 92300 comprises a tissue bite region havinga larger width than its shaft diameter. The end effector 92320 ishingedly coupled to the shaft 92310. The collapsible suturing device92300 comprises a separate actuation member to rotate the end effector92320 relative to the shaft 92310. In other embodiments, the endeffector 92320 can be spring biased into a straight configuration wherea user may apply torque to a distal end of the end effector 92320 bypressing the end effector 92320 against tissue to rotate the endeffector 92320 relative to the shaft 92310. In either event, such anarrangement provides the device 92300 with a distal-facing tissue biteregion 92321 which can permit a user to more accurately and/or easilytarget tissue to be sutured.

The tissue bite region 92321 is larger than the diameter of the shaft92310. During use, a user would insert the collapsible suturing device92300 into a trocar while the device 92300 is in its straightconfiguration. After the device 92300 is inserted through the trocar,the user may actively rotate the end effector 92320 with an actuator toorient the end effector 92320 properly to prepare to suture the tissue.Once the end effector 92320 is oriented to face the tissue to besutured, a movable needle guide may be actuated outwardly to prepare toadvance the needle through a needle firing stroke. In thisconfiguration, the end effector 92320 can then be pressed against thetissue to be sutured and the needle can be advanced through a needlefiring stroke. Once suturing is complete, the needle guide can becollapsed and the end effector 92320 can be rotated back into itsstraight configuration to be removed from the patient through thetrocar. The needle may be taken out of the end effector 92320 before orafter the end effector 92320 has passed back out of the patient throughthe trocar.

FIG. 18 depicts a collapsible suturing device 92400 comprising a shaft92410 and an end effector 92420 attached to the distal end of the shaft92410. The device 92400 comprises a tissue bite region having a largerwidth than its shaft diameter. The end effector 92420 further comprisesa needle driving system 92430 configured to drive a flexible needlethrough a needle firing stroke against a movable needle guide 92440. Theneedle driving system 92430 comprises a proximal feed wheel 92431, adistal feed wheel 92433, and an intermediate feed wheel 92435 configuredto feed the flexible needle through the end effector 92420. Theintermediate feed wheel 92435 permits the use of a longer flexibleneedle than arrangements without an intermediate feed wheel. Embodimentsare envisioned where the intermediate feed wheel is actively connectedthe needle driving system. In other instances, the intermediate feedwheel is an idler component and rotates freely. In at least oneembodiment, the needle comprises a width that is larger than the widthof the shaft with which is used.

FIGS. 19-21 depict a surgical suturing end effector 91600 configured toprovide a suturing device with a variable needle stroke. In variousinstances, the needle stroke of the end effector 91600 can be differentevery time the end effector 91600 is fired. The end effector 91600 alsocan provide a suturing bite width that is wider than the diameter of itsshaft. The surgical suturing end effector 91600 comprises a body portion91610 having a tissue-engaging opening 91612, a needle track 91620defined within the body portion 91610, and a needle 91630 configured tobe guided through a firing stroke by the needle track 91620. FIG. 19illustrates the needle 91630 in its parked position where the endeffector 91600 can be passed through a trocar. Once the end effector91600 is passed through a trocar, the needle 91630 is advanced linearlyfrom a park track portion 91621 of the needle track 91620—by way of itsproximal end 91633—to a ready-to-fire position (FIG. 20 ). As can beseen in FIG. 20 , the needle 91630 extends outwardly beyond the body91610 of the end effector 91600 when the needle 91630 is in itsready-to-fire position. Such an arrangement allows for an instrument tohave a tissue bite width that is larger than the diameter of theinstrument's shaft. The needle 91630 comprises a canoe-like shape butcan comprise any suitable shape to achieve this.

When a clinician wants to complete a suture stroke, discussed in greaterdetail below, the needle 91630 is moved to the position shown in FIG. 21referred to as the hand-off position. To get to this position, theproximal end 91633 of the needle 91630 is rotated and advanced linearlywithin a first track portion 91622 of the track 91620 until the proximalend 91633 of the needle 91630 reaches a distal end 91623 of the firsttrack portion 91622 and a tip portion 91634 of the needle 91630 engagesa distal end 91625 of a second track portion 91624 of the track 91620.This engagement allows a needle driver that rotates and linearlyadvances the needle 91630 within the track 91620 to move along the track91620 to the distal end 91625 of the second track portion 91624 to grabthe tip portion 91634 and pull the needle 91630 through the end effector91600 by pulling the needle 91630 proximally and rotating the needle91630 to prepare for a second firing stroke of the needle 91630. At acertain point after the needle 91630 attains the hand-off position (FIG.21 ), the needle driver can re-connect, or re-engage, with the proximalend 91633 of the needle 91630 to begin a second firing stroke to returnthe needle 91630 to its ready-to-fire position illustrated in FIG. 20 .The firing stroke of the needle 91630, having a canoe-like shape, canresemble a box-shaped, or diamond-shaped, path.

FIG. 22 is a stress-strain diagram 91700 of the loads experienced by aneedle during a firing stroke. A control system of a surgical suturinginstrument can monitor input from a strain gauge and adjust theoperation of the surgical suturing instrument based on the monitoredstrain and/or display the strain to a user during use. The surgicalsuturing instrument can alert a user when the needle has reached 75%91701 of its yield strength during a suturing procedure. The surgicalinstrument can provide the clinician with an option to adjust theadvancement speed of the needle to help prevent further spikes of thestrain and/or stress within the needle. If the needle reaches 100% 91703of its yield strength, overstress may be reported to the user and thecontrol system will report the overstress to the system disclosed inU.S. patent application Ser. No. 15/908,021, entitled SURGICALINSTRUMENT WITH REMOTE RELEASE, filed on Feb. 28, 2018, U.S. patentapplication Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVINGDUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTORMOVEMENT, filed on Feb. 28, 2018, U.S. patent application Ser. No.15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S.patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,058,entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed on Feb.28, 2018, and U.S. patent application Ser. No. 15/908,143, entitledSURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed on Feb.28, 2018, which are incorporated in their entireties herein. If theneedle reaches 125% 91705 of its yield strength, the user is alerted ofthis threshold and the control program automatically slows the speed andmay disable the instrument from actuating the needle any further, and/orrequest action to be taken before any further use of the surgicalsuturing instrument.

FIGS. 23 and 24 depict a method for detecting the proper and/or improperattachment of a modular shaft to a surgical instrument handle and/orsurgical robot, for example. FIG. 23 depicts an attachment assembly91800 attachable to an attachment interface 91810—which can be asurgical instrument handle and/or robotic attachment, or control,interface. Monitoring the torque of a drive system coupled at theattachment interface 91810 can provide a way to determine if theattachment interface 91810 and the modular attachment 91820 have beensuccessfully attached or not.

Referring to the graph 91830, the solid plot line represents a scenariowhere an attempt at attaching the modular attachment 91820 to theattachment interface 91810 was made, and the modular attachment 91820and the attachment 91830 slipped out of engagement thereby causing areduction in torque of the actuation drive system below a minimum torquethreshold representing an unsuccessful attachment and engagement ofdrive systems. The torque of a failed attempt is noticeably differentthan the torque of a successful attempt which is also illustrated in thegraph 91830. In another embodiment, the current of the motor that drivesthe drive system can be directly monitored. Referring now to the graph91830′, the surgical instrument is equipped with a control system thatshuts off the motor in this scenario (1) when the torque sensed dropsbelow the minimum threshold torque. The control system can also alert auser that the motor has been stopped because attachment was notsuccessful. Referring again to the graph 91830, a second scenario isillustrated by a dashed plot line where attachment is made, however, thetorque sensed increases above a maximum torque threshold. This couldindicate a jam between the attachment interface 91810 and the modularattachment 91820. Referring again to the graph 91830′, the surgicalinstrument is equipped with a control system that limits the torquedelivered by the drive system when the torque sensed increases above themaximum threshold torque, as illustrated in the dashed plot linerepresenting the second scenario (2). Such a limiting of torque deliverycan prevent the breaking of components in the modular attachment 91820and/or the attachment interface 91810.

In various embodiments, strain gauges can be fitted to frame elements ofthe modular attachments to monitor force applied to tissue with theframe elements themselves. For example, a strain gauge can be fitted toan outer shaft element to monitor the force experienced by the shaft asthe modular attachment is pushed against tissue and/or as the modularattachment pulls tissue. This information can be communicated to theuser of the instrument so that the user is aware of the pressure beingapplied to the tissue by the grounded elements of the modular attachmentdue to manipulation and movement of the modular attachment within thesurgical site.

FIGS. 25 and 26 depict a surgical instrument system 91910 that isconfigured to monitor unexpected electrical potential applied to asurgical instrument during an operation that involves using a mono-polarbridge instrument. FIG. 25 depicts a system 91910 comprising a grasper91912 and a mono-polar bridge instrument 91914 being used in the samesurgical site. In one scenario, now referring to the graph 91930 in FIG.26 , the voltage potential of the grasper 91912 can be monitoredthroughout the use of the system 91910 during an operation. Stage (1) ofthe graph 91920 represents the beginning of articulation of the grasper91912 using motorized articulation. Stage (2) represents a spike indetected voltage potential of the grasper 91912. Such a spike in voltagepotential can be conducted to the grasper 91912 by way of the mono-polarbridge instrument 91914. At this stage, the system 91910 canautomatically reverse the motor direction Stage (3) of articulation tomove the grasper 91912 away from the mono-polar bridge instrument 91914until the unexpected voltage spike subsides Stage (4). The controlprogram of the system 91910 can then instruct the articulation motor toautomatically reverse the articulation a predetermined amount passed thepoint when the system 91910 no longer detects the voltage spike toensure that this voltage spike will not occur again due to minorinadvertent movement of either the grasper 91912 and/or the mono-polarbridge instrument 91914.

The surgical instrument can also alert the user when an unexpectedvoltage potential is detected and await further action by a user of theinstrument. If the user is using the instrument that experiences thevoltage spike as a mono-polar bridge instrument then the user couldinform the instrument of this to continue actuation of the instrument.The instrument can also include an electrical circuit, or ground path,to interrupt the flow of electricity beyond a dedicated position whenthe instrument experiences an unexpected voltage potential. In at leastone instance, the ground path can extend within a flex circuit extendingthroughout the shaft.

FIG. 27 illustrates a logic diagram of a process 93900 depicting acontrol program for controlling a surgical instrument. The process 93900comprises sensing 93901 an electrical potential applied to theinstrument. For example, the voltage of an electrical circuit whichincludes the instrument can be monitored. The process 93900 furtherincludes determining 93903 if the sensed electrical potential is above apredetermined threshold based on the sensed electrical potential. Aprocessor, for example, can monitor the voltage and, if a voltage spikeoccurs, the processor can change the operation of the surgicalinstrument. For instance, the process can adjust 93907 the controlmotions of the instrument such as reversing a previous motion, forexample. If the sensed electrical potential is below the predeterminedthreshold, the control program can continue 93905 the normal operationof the instrument.

In various embodiments, surgical suturing instruments can include meansfor detecting the tension of the suture during the suturing procedure.This can be achieved by monitoring the force required to advance aneedle through its firing stroke. Monitoring the force required to pullthe suturing material through tissue can indicate stitch tightnessand/or suture tension. Pulling the suturing material too tight during,for example, tying a knot can cause the suturing material to break. Theinstrument can use the detected forces to communicate stitch tightnessto the user during a suturing procedure and let the user know that thestitch is approaching its failure tightness or, on the other hand, isnot tight enough to create a sufficient stitch. The communicated stitchtightness can be shown to a user during a suturing procedure in aneffort to improve the stitch tightness throughout the procedure.

In various embodiments, a surgical suturing instrument comprises amethod for detecting load within the end effector, or head, of theinstrument, and a control program to monitor this information andautomatically modify, and/or adjust, the operation of the instrument. Inone instance, a needle holder and/or a needle drive can comprise astrain gauge mounted thereon to monitor the force and stress beingexperienced by the needle during its firing stroke. A processor of theinstrument can monitor the strain sensed by the strain gauge bymonitoring the voltage reading that the strain gauge provides and, ifthe force detected is above a predetermined threshold, the processor canslow the needle and/or alert a user of the instrument that the needle isexperiencing a force greater than a certain threshold. Other parameters,such as needle velocity and/or acceleration, for example, can bemonitored and used to modify the operation of the surgical instrument.

Many different forces experienced by a surgical suturing instrument canbe monitored throughout a suturing procedure to improve efficiency ofthe operation. FIG. 28 depicts a surgical suturing instrument 92200comprising a shaft 92210, an end effector 92230, and an articulationjoint 92220 attaching the end effector 92230 to the shaft 92210 andpermitting articulation of the end effector 92230 relative to the shaft92210. The end effector 92230 comprises a frame 92232 and a suturecartridge 92234. The cartridge 92234 comprises a needle 92236 comprisingsuturing material 92238 attached thereto configured to pass throughtissue T.

Various parameters of the instrument 92200 can be monitored during asurgical suturing procedure. The force, or load, experienced by theneedle 92236 can be monitored, the torque load that resists distal headrotation of the end effector 92230 can be monitored, and/or the bendingload of the shaft 92210 that can cause drive systems within the shaft tobind up can be monitored. The monitoring of these parameters isillustrated in the graph 92100 in FIG. 29 . The surgical instrument92200 is configured to limit corresponding motor current if certainthresholds of the parameters are exceeded. The force experienced by theneedle 92236 is represented by the solid plot line in the graph 92100.This force can directly correspond to the current drawn by the motorthat fires the needle 92236. As the load on the needle 92236 increases,the motor that is firing the needle slows down thereby reducing the loadon the needle and reducing current through the motor. If this force, orcurrent, exceeds a certain pre-determined threshold, the power appliedto the needle firing motor can be limited to prevent possible failure ofdrive system components and/or driving a needle through an unintendedtarget. This limiting event is labeled (1) in the reaction graph 92120.The torque load experienced by the end effector 92230 is represented bythe dashed plot in the graph 92100. This torque load can be a result oftrying to rotate the end effector 92230 while the suturing material92238 is still connected to tissue T and the needle 92236. This torqueload can directly correspond to the current of the motor that rotatesthe end effector 92230. If this torque load, or current, exceeds acertain pre-determined threshold, power to the motor that rotates theend effector 92230 can be limited. This limiting event is labeled (2) inthe reaction graph 92120. The bending load experienced by the shaft92210 is represented by the dash-dot plot in the graph 92100 and can besensed by using a strain gauge placed on the shaft 92210, for example.If this bending load exceeds a certain pre-determined threshold, powerto the motor that rotates the end effector 92230 can be limited andreduced. This limiting event is labeled (3) in the reaction graph 92120.

FIG. 30 illustrates a logic diagram of a process 94000 depicting acontrol program for controlling a surgical suturing instrument. Theprocess 94000 comprises monitoring 94001 one or more detectableparameters of the surgical suturing instrument. For example, the forceexperienced by the suturing needle, the torque load experienced by theshaft of the instrument, and/or the torque load experienced by the endeffector of the instrument can be monitored. In fact, any combination ofdetectable parameters can be monitored. The process 94000 furtherincludes determining 94003 if the detected parameters warrant a changein the operation of the instrument. For example, if the shaft isexperiencing a torque load that is greater than a predeterminedthreshold, the control program can adjust 94007 the control motionsapplied to the end effector, such as stopping the actuation of theinstrument, until the torque experienced by the shaft falls below thepredetermined threshold. If all of the detected parameters are withinoperational conditions, the control program can continue 94005 thenormal operation of the instrument.

Another system for detecting and/or monitoring the location of thesuturing needle during its firing stroke can include utilizing one ormore magnets and Hall Effect sensors. In such an embodiment, a permanentmagnet can be placed within and/or on the needle and a Hall Effectsensor can be placed within, or adjacent to, the needle track, forexample. In such an instance, movement of the needle will cause themagnet to move into, within, and/or out of the field created by the HallEffect sensor thereby providing a way to detect the location of theneedle. In the same embodiment, and/or in another embodiment, a magnetcan be placed on one side of the needle track and a corresponding HallEffect sensor can be placed on the other side of the needle track. Insuch an embodiment, the needle itself can interrupt the magnetic fieldbetween the magnet and the Hall Effect sensor as the needle passesbetween the two magnets, thereby providing a way to detect the locationof the needle.

FIGS. 31 and 32 depict a surgical suturing end effector assembly 93100configured to suture the tissue of a patient during a surgical suturingprocedure. The end effector assembly 93100 comprises a shaft 93110 andan end effector 93120 extending distally from the shaft 93110. The endeffector 93120 comprises a first jaw 93130 and a second jaw 93140configured to receive a replaceable suturing cartridge 93141 therein.The suturing cartridge 93141 comprises a needle 93152 and suturematerial 93150 attached thereto configured to be driven through a needlefiring stroke and guided by a needle track 93142 in the suturingcartridge 93141.

The surgical suturing end effector assembly 93100 further comprises aneedle sensing system comprising a magnet 93162 and a Hall Effect sensor93164. The magnet 93162 and Hall Effect sensor 93164 are positionedwithin the suturing cartridge 93141 such that the needle 93152 isconfigured to interrupt the magnetic field between the magnet 93162 andthe Hall Effect sensor 93164. Such an interruption can indicate to acontrol program the position of the needle 93152 relative to thesuturing cartridge 93141 and/or within its firing stroke. The sensor andmagnet may be embedded within the cartridge and/or placed adjacent theneedle track such as, for example, on top of, on bottom of, and/or onthe sides of the needle track.

FIG. 33 depicts a needle sensing system 93200 positioned within asuturing cartridge 93240. The suturing cartridge 93240 comprises aneedle 93252 and a needle track 93242 configured to guide the needle93252 through a needle firing stroke. The needle sensing system 93200comprises a magnet 93264 and a Hall Effect sensor 93262 positioned aboveand below, respectively, the needle track 93242. The Hall Effect sensor93262 and the magnet 93264 are configured to indicate the position ofthe needle to a control circuit as the needle interrupts the magneticfield between the Hall Effect sensor 93262 and the magnet 93264. Such anarrangement can provide a more localized needle position detectionsystem. In at least one embodiment, a suturing cartridge can containmore than one Hall Effect sensor and magnet arranged in this manner toprovide multiple detection locations along the needle track. That said,any suitable sensor arrangement can be used. A control program candetermine the position of the needle based on the sensor reading(s) ofthe Hall Effect sensor(s). A control program of the surgical instrumentcan adjust control motions applied to the surgical suturing instrumentbased on the readings from the Hall Effect sensor(s). For example, ifthe needle is detected to be moving slower than preferred during afiring stroke based on the time it takes for the needle to tripconsecutive sensors, the control program can increase the speed of themotor driving the needle through its firing stroke. Also, for example,the control program can compensate for a lag in the position of theneedle during its stroke. In at least one instance, the electrical motorof the needle firing drive can be left on for a few additional rotationsto reposition the needle in its stroke.

Another system for detecting and/or monitoring the location of thesuturing needle during its firing stroke can include utilizing one ormore proximity sensors near the needle and/or the needle driver. Asdiscussed above, the needle driver is configured to drive the needle outof its needle track and back into the other side of the needle track,release the needle, and return to its original position to grab theneedle on the other side of the track to prepare for a second half of afiring stroke. The proximity sensor(s) can be used to monitor thelocation of the needle and/or the needle driver. In an instance wheremultiple proximity sensors are used, a first proximity sensor can beused near the entry point on the needle track and a second proximitysensor can be used near the exit point on the needle track, for example.

FIG. 34 depicts a needle sensing system 93300 positioned within asuturing cartridge 93340. The suturing cartridge 93340 comprises aneedle 93352 and a needle track 93342 configured to guide the needle93352 through a needle firing stroke. The needle sensing system 93300comprises a plurality of proximity sensors 93362 positioned within theneedle track 93342. In at least one embodiment, the sensors 93362 aremolded into a sidewall 93343 of the needle track 93342. In the sameembodiment and/or another embodiment, the sensors 93362 are molded intoa top, or bottom, surface 93345 of the needle track 93342. Any suitablelocation within the end effector assembly can be used. The sensorinformation can be used to determine the location of the needle 93352which can then be used to modify the operation of the surgicalinstrument if appropriate.

In at least one embodiment, a plurality of proximity sensors can be usedwithin the end effector of a suturing device to determine if a needle ofthe suturing device has been de-tracked or fallen out of its track. Toachieve this, an array of proximity sensors can be provided such thatthe needle contacts at least two sensors at all times during its firingstroke. If a control program determines that only one sensor iscontacted based on the data from the proximity sensors, the controlsystem can then determine that the needle has been de-tracked and modifythe operation of the drive system accordingly.

FIG. 35 depicts a needle sensing system 93400 positioned within asuturing cartridge 93440. The suturing cartridge 93440 comprises aneedle 93452 and a needle track 93442 configured to guide the needle93452 through a needle firing stroke. The needle sensing system 93400comprises a plurality of conductive sensors 93462 positioned within theneedle track 93442. In one embodiment, the sensors 94362 are positionedadjacent a sidewall 93443 of the needle track 93442 such that the needle93452 may progressively contact the sensors 94362 as the needle 93452progresses through a needle firing stroke. In the same embodiment and/oranother embodiment, the sensors 93462 are positioned adjacent a top, orbottom, surface 93445 of the needle track 93442. Any suitable locationwithin the end effector assembly can be used. The sensor information canbe used to determine the location of the needle 93452 which can then beused to modify the operation of the surgical instrument if appropriate.

Another system for detecting and/or monitoring the location of thesuturing needle during its firing stroke can include placing a circuitin communication with the needle track. For example, a conductive supplyleg can be wired in contact with one side of the needle track and aconductive return leg can be wired in contact with the other side of theneedle track. Thus, as the needle passes by the circuit, the needle canact as a circuit switch and complete the circuit to lower the resistancewithin the circuit thereby providing a way to detect and/or monitor thelocation of the needle. Several of these circuits can be placedthroughout the needle track. To aid the needle conductivity between thecircuit contacts, brushes can be used to cradle the needle as the needlepasses the circuit location. A flex circuit can also be used and can beadhered to inner walls of the needle track, for example. The flexcircuit can contain multiple contacts, and/or terminals. In at least oneinstance, the contacts can be molded directly into the walls. In anotherinstance, the contacts of the flex circuit can be folded over an innerwall of the needle track and stuck to the wall with an adhesive, forexample, such that the contacts face the needle path. In yet anotherinstance, both of these mounting options can be employed.

Another system for detecting and/or monitoring the location of thesuturing needle during its firing stroke can include one or moreinductive sensors. Such sensors can detect the needle and/or the needlegrabber, or driver.

Another system for detecting and/or monitoring the location of thesuturing needle during its firing stroke can include using a lightsource and a photodetector which are positioned such that movement ofthe needle interrupts the detection of the light source by thephotodetector. A light source can be positioned within, and/or near, theneedle track, for example, and faced toward the needle path. Thephotodetector can be positioned opposite the light source such thatneedle can pass between the light source and the photodetector therebyinterrupting the detection of light by the photodetector as the needlepasses between the light source and the photodetector. Interruption ofthe light provided by the light source can indicate the needle'spresence or lack thereof. The light source may be an infrared LEDemitter, for example. Infrared light may be preferred due to its abilityto penetrate tissue and organic debris, especially within a suturingsite, which otherwise could produce a false positive reading by thephotodetector. That said, any suitable light emitter could be used.

FIG. 36 depicts a needle sensing system 93500 positioned within asuturing cartridge 93540. The suturing cartridge 93540 comprises aneedle 93552 and a needle track 93542 configured to guide the needle93552 through a needle firing stroke. The needle sensing system 93500comprises a light source 93562 positioned at an entry point 93545 of theneedle track 93542 and a photodetector 93564 positioned at an exit point93543 of the needle track 93542. When the needle 93552 is in its homeposition as illustrated in FIG. 36 , the light source 93562 isconfigured to emit light that spans across the capture opening of thesuturing cartridge 93540 to indicate that the needle 93552 is in itshome position. Once the needle 93552 interrupts the path between thelight source 93562 and the photodetector 93564, a control program candetermine that the needle is not in its home position. The location ofthe needle 93552 can be determined by a control program based on theinterruption of light between the light sources and photodetectors whichcan then be used to modify the operation of the surgical instrument ifappropriate.

FIG. 37 depicts a needle sensing system 93600 positioned within asuturing cartridge 93640. The suturing cartridge 93640 comprises aneedle 93652 and a needle track 93642 configured to guide the needle93652 through a needle firing stroke. The needle sensing system 93600comprises a light source 93662 and a photodetector 93664 positioned atan exit point 93643 of the needle track 93642. The light source 93662 isconfigured to emit light that spans across the needle track cavity ofthe suturing cartridge 96640 to indicate the position of the needle93652. In another embodiment, another photodetector and light source arepositioned at an exit point 93645 of the needle track 93642. In yetanother embodiment, an array of photodetectors and light sources areplaced along the length of the needle track 93642. The location of theneedle 93652 can be determined by a control program based on theinterruption of light between the light source 93662 and thephotodetector 93664.

In at least one embodiment, a surgical suturing needle can comprise ahelical profile to provide helical suturing strokes. Such a needlecomprises a length spanning 360 degrees where a butt end of the needleand a tip of the needle do not reside in the same plane and define avertical distance therebetween. This needle can be actuated through ahelical, or coil shaped, stroke to over-sew a staple line, for example,providing a three dimensional needle stroke. A needle having the helicalshape discussed above provides a three dimensional suturing path.

FIGS. 38 and 39 depict a helical suturing needle assembly 93700 for usewith a surgical suturing instrument. The suturing needle assembly 93700comprises a tip 93704, a proximal end 93706, and a helical body portion93702 extending therebetween. The helical body portion 93702 comprises acatch feature 93701 that a needle driver of a surgical suturinginstrument is configured to catch on a return stroke of the driver. Thetip 93704 and the proximal end 93706 reside in different horizontalplanes and comprise a vertical distance therebetween; however, the tip93704 and the proximal end 93706 terminate along a common axis A (FIG.39 ). The needle assembly 93700 can be actuated through a helical, orcoil shaped, stroke to over-sew a staple line, for example, providing athree dimensional needle stroke.

In various instances, the needle comprises a circular configuration thatis less than 360 degrees in circumference. In at least one instance, theneedle can be stored in the end effector in an orientation which storesthe needle within the profile of the end effector. Once the end effectoris positioned within the patient, the needle can be rotated out of itsstored position to then perform a firing stroke.

In various embodiments, a surgical suturing instrument can accommodatedifferent needle and suture sizes for different suturing procedures.Such an instrument can comprise a means for detecting the size of theneedle and/or suture loaded into the instrument. This information can becommunicated to the instrument so that the instrument can adjust thecontrol program accordingly. Larger diameter needles may be rotatedangularly at a slower rate than smaller diameter needles. Needles withdifferent lengths may also be used with a single instrument. In suchinstances, a surgical instrument can comprise means for detecting thelength of the needle. This information can be communicated to a surgicalinstrument to modify the needle driver's path, for example. A longerneedle may require a smaller stroke path from the needle driver tosufficiently advance the longer needle through its firing stroke asopposed to a smaller needle which may require a longer stroke path fromthe needle driver to sufficiently advance the shorter needle through itsfiring stroke in the same needle track.

FIG. 40 depicts a logic diagram of a process 94100 depicting a controlprogram for controlling a surgical instrument. The process 94100comprises detecting 94101 the type of suturing cartridge installedwithin the surgical suturing instrument. In various instances, differentsuture cartridges may have different suture lengths, needle lengths,needle diameters, and/or suture materials, for example. The type ofsuture cartridge and/or its characteristics can be communicated to acontrol circuit by an identification chip positioned within thecartridge such that, when a suture cartridge is installed within asurgical instrument, the control circuit can identify what type ofcartridge has been installed and assess the characteristics of thesuture cartridge. In order to accommodate different cartridge types, acontrol circuit may adjust the control motions that will be applied tothe suture cartridge. For example, firing speeds may differ fordifferent sized needles. Another example may include adjusting the rangeof angular needle rotation based on different needle lengths, or sizes.To accommodate such differences, the process 94100 implemented by aprocess, for example, comprises adjusting 94103 a motor control programof the instrument based on what type of suture cartridge is installed.

In at least one embodiment, a suture needle is stored in a suturinginstrument in a folded manner. In at least one such instance, the sutureneedle comprises two portions which are hingedly connected to oneanother at a hinge. After the end effector has been passed through thetrocar, the suture needle can be unfolded and locked into its unfoldedconfiguration. In at least one instance, a one-way snap feature can beused to rigidly hold the suture needle in its unfolded configuration.

In at least one embodiment, a surgical instrument is configured to applya suture to the tissue of a patient which comprises a lockout system.The lockout system comprises a locked configuration and an unlockedconfiguration. The surgical instrument further comprises a controlcircuit and is configured to identify if a cartridge is installed or notinstalled within an end effector of the surgical instrument. The controlcircuit is configured to place the lockout system in the lockedcondition when a cartridge is not installed in the end effector andplace the lockout system in the unlocked condition when a cartridge isinstalled in the end effector. Such a lockout system can include anelectrical sensing circuit of which a cartridge can complete uponinstallation indicating that a cartridge has been installed. In at leastone instance, the actuator comprises an electric motor and the lockoutsystem can prevent power from being supplied to the electric motor. Inat least one instance, the actuator comprises a mechanical trigger, andthe lockout system blocks the mechanical trigger from being pulled toactuate the suture needle. When the lockout system is in the lockedconfiguration, the lockout system prevents an actuator from beingactuated. When the lockout system is in the unlocked configuration, thelockout system permits the actuator to deploy the suture positionedwithin the cartridge. In one embodiment, the control circuit provideshaptic feedback to a user of the surgical instrument when the electricalsensing circuit places the surgical instrument in the lockedconfiguration. In one embodiment, the control circuit prevents theactuation of an electric motor configured to actuate the actuator whenthe electrical sensing circuit determines that the lockout system is inthe locked configuration. In one embodiment, the lockout system is inthe unlocked configuration when a cartridge is positioned in the endeffector and the cartridge has not been completely expended.

FIGS. 41 and 42 depict a handle assembly 95200 that is operable for usea surgical suturing instrument. The handle assembly 95200 is connectedto a proximal end of a shaft. The handle assembly 95200 includes a motor95202 and a transmission assembly 95210. The motor 95202 is configuredto actuate a needle of a surgical suturing end effector by way of aneedle driver, articulate the end effector, and rotate the end effectorby way of the transmission assembly 95210. The transmission assembly95210 is shifted between three states by a double acting solenoid, forexample, so as to allow the motor 95202 to be used to actuate a needleof a surgical suturing end effector, articulate the end effector, and/orrotate the end effector. In at least one embodiment, the handle assembly95200 could take the form of a robotic interface or a housing comprisinggears, pulleys, and/or servomechanisms, for example. Such an arrangementcould be used with a robotic surgical system.

FIG. 43 depicts a suturing cartridge 93590 comprising a lower body93581, an upper body 93582, and a needle cover 93583. The cartridge93590 further comprises a drive system comprising a needle driver 93586,a rotary input 93594, and a link 93585 connecting the needle driver93586 and the rotary input 93594. The needle driver 93586, rotary input93594, and link 93585 are captured between the lower body 93581 and theupper body 93582. The needle driver 93586, the link 93585, and therotary input 93594 are configured to be actuated to drive a needle 93570through a needle firing stroke by way of a motor-driven system, amanually-driven handheld system, and/or a robotic system, for example.The lower and upper bodies 93581, 93582 are attached to one anotherusing any suitable technique, such as, for example, welds, pins,adhesives, and/or the like to form the cartridge body. The needle 93570comprises a leading end 93571 configured to puncture tissue, a trailingend 93572, and a length of suture 93573 extending from and attached tothe trailing end 93572. The needle 93570 is configured to rotate in acircular path defined by a needle track 93584. The needle track 93584 isdefined in the cartridge body. The needle 93570 is configured to exitone of a first arm 95393A and a second arm 95393B of the cartridge bodyand enter the other of the first arm 95393A and the second arm 95393Bduring a needle firing stroke. Recessed features 93574 are provided toso that the needle driver 93586 can engage and drive the needle 93570through the needle firing stroke in a ratchet-like motion. The needle93570 is positioned between the needle track 93584 and the needle cover93583. The suturing cartridge 93590 further comprises a cage 93587 thatis configured to slide over the cartridge body to attach the needlecover 93583 to the lower body 93581.

A surgical system 128000 is illustrated in FIG. 44 . The surgical system128000 comprises a handle, a shaft 128020 extending from the handle, andan end effector 128030 extending from the shaft 128020. In alternativeembodiments, the surgical system 128000 comprises a housing configuredto be mounted to a robotic surgical system. In at least one suchembodiment, the shaft 128020 extends from the robotic housing mountinstead of the handle. In either event, the end effector 128030comprises jaws 128040 and 128050 which are closeable to grasp a target,such as the tissue T of a patient and/or a suture needle, for example,as discussed in greater detail below. The jaws 128040 and 128050 arealso openable to dissect the tissue of a patient, for example. In atleast one instance, the jaws 128040 and 128050 are insertable into thepatient tissue to create an otomy therein and then spread to open theotomy, as discussed in greater detail below.

Referring again to FIG. 44 , the jaws 128040 and 128050 are pivotablycoupled to the shaft 128020 about a pivot joint 128060. The pivot joint128060 defines a fixed axis of rotation, although any suitablearrangement could be used. The jaw 128040 comprises a distal end, ortip, 128041 and an elongate profile which narrows from its proximal endto its distal end 128041. Similarly, the jaw 128050 comprises a distalend, or tip, 128051 and an elongate profile which narrows from itsproximal end to its distal end 128051. The distance between the tips128041 and 128051 define the mouth width, or opening, 128032 of the endeffector 128030. When the tips 128041 and 128051 are close to oneanother, or in contact with one another, the mouth 128032 is small, orclosed, and the mouth angle θ is small, or zero. When the tips 128041and 128051 are far apart, the mouth 128032 is large and the mouth angleθ is large.

Further to the above, the jaws of the end effector 128030 are driven bya jaw drive system including an electric motor. In use, a voltagepotential is applied to the electric motor to rotate the drive shaft ofthe electric motor and drive the jaw drive system. The surgical system128000 comprises a motor control system configured to apply the voltagepotential to the electric motor. In at least one instance, the motorcontrol system is configured to apply a constant DC voltage potential tothe electric motor. In such instances, the electric motor will run at aconstant speed, or an at least substantially constant speed. In variousinstances, the motor control system comprises a pulse width modulation(PWM) circuit and/or a frequency modulation (FM) circuit which can applyvoltage pulses to the electric motor. The PWM and/or FM circuits cancontrol the speed of the electric motor by controlling the frequency ofthe voltage pulses supplied to the electric motor, the duration of thevoltage pulses supplied to the electric motor, and/or the durationbetween the voltage pulses supplied to the electric motor.

The motor control system is also configured to monitor the current drawnby the electric motor as a means for monitoring the force being appliedby the jaws of the end effector 128030. When the current being drawn bythe electric motor is low, the loading force on the jaws is low.Correspondingly, the loading force on the jaws is high when the currentbeing drawn by the electric motor is high. In various instances, thevoltage being applied to the electric motor is fixed, or held constant,and the motor current is permitted to fluctuate as a function of theforce loading at the jaws. In certain instances, the motor controlsystem is configured to limit the current drawn by the electric motor tolimit the force that can be applied by the jaws. In at least oneembodiment, the motor control system can include a current regulationcircuit that holds constant, or at least substantially constant, thecurrent drawn by the electric motor to maintain a constant loading forceat the jaws.

The force generated between the jaws of the end effector 128030, and/oron the jaws of the end effector 128030, may be different depending onthe task that the jaws are being used to perform. For instance, theforce needed to hold a suture needle may be high as suture needles aretypically small and it is possible that a suture needle may slip duringuse. As such, the jaws of the end effector 128030 are often used togenerate large forces when the jaws are close together. On the otherhand, the jaws of the end effector 128030 are often used to applysmaller forces when the jaws are positioned further apart to performlarger, or gross, tissue manipulation, for example.

Referring to the upper portion 128110 of the graph 128100 illustrated inFIG. 45 , the loading force, f, experienced by the jaws of the endeffector 128030 can be limited by a force profile stored in the motorcontrol system. The force limit profile 128110 o for opening the jaws128040 and 128050 is different than the force limit profile 128110 c forclosing the jaws 128040 and 128050. This is because the proceduresperformed when forcing the jaws 128040 and 128050 open are typicallydifferent than the procedures performed when forcing the jaws 128040 and128050 closed. That said, the opening and closing force limit profilescould be the same. While it is likely that the jaws 128040 and 128050will experience some force loading regardless of whether the jaws 128050are being opened or closed, the force limit profiles typically come intoplay when the jaws 128040 and 128050 are being used to perform aparticular procedure within the patient. For instance, the jaws 128040and 128050 are forced open to create and expand an otomy in the tissueof a patient, as represented by graph sections 128115 and 128116,respectively, of graph 128100, while the jaws 128040 and 128050 areforced closed to grasp a needle and/or the patient tissue, asrepresented by graph sections 128111 and 128112, respectively, of graph128100.

Referring again to FIG. 45 , the opening and closing jaw force limitprofiles 128110 o and 128110 c, respectively, are depicted on theopposite sides of a zero force line depicted in the graph 128100. As canbe seen in the upper section 128110 of graph 128100, the jaw force limitthreshold is higher—for both force limit profiles 128110 o and 128110c—when the jaws 128040 and 128050 are just being opened from theirfully-closed position. As can also be seen in the upper section 128110of graph 128100, the jaw force limit threshold is lower—for both forcelimit profiles 128110 o and 128110 c—when the jaws 128040 and 128050 arereaching their fully-opened position. Such an arrangement can reduce thepossibility of the jaws 128040 and 128050 damaging adjacent tissue whenthe being fully opened, for example. In any event, the force that thejaws 128040 and 128050 are allowed to apply is a function of the mouthopening size between the jaws and/or the direction in which the jaws arebeing moved. For instance, when the jaws 128040 and 128050 are openedwidely, or at their maximum, to grasp large objects, referring to graphsection 128114 of upper graph section 128110, the jaw force f limit isvery low as compared to when the jaws 128040 and 128050 are more closedto perform gross tissue manipulation, referring to graph section 128113of upper graph section 128110. Moreover, different jaw force limitprofiles can be used for different jaw configurations. For instance,Maryland dissectors, which have narrow and pointy jaws, may have adifferent jaw force limit profile than a grasper having blunt jaws, forexample.

In addition to or in lieu of the above, the speed of the jaws 128040 and128050 can be controlled and/or limited by the motor control system as afunction of the mouth opening size between the jaws 128040 and 128050and/or the direction the jaws are being moved. Referring to the middleportion 128120 and lower portion 128130 of the graph 128100 in FIG. 45 ,the rate limit profile for moving the jaws 128040 and 128050 permits thejaws to be moved slowly when the jaws are near their closed position andmoved quickly when the jaws are near their open position. In suchinstances, the jaws 128040 and 128050 are accelerated as the jaws areopened. Such an arrangement can provide fine control over the jaws128040 and 128050 when they are close together to facilitate the finedissection of tissue, for example. Notably, the rate limit profile foropening and closing the jaws 128040 and 128050 is the same, but theycould be different in other embodiments. In alternative embodiments, therate limit profile for moving the jaws 128040 and 128050 permits thejaws to be moved quickly when the jaws are near their closed positionand slowly when the jaws are near their open position. In suchinstances, the jaws 128040 and 128050 are decelerated as the jaws areopened. Such an arrangement can provide fine control over the jaws128040 and 128050 when the jaws are being used to stretch an otomy, forexample. The above being said, the speed of the jaws 128040 and 128050can be adjusted once the jaws experience loading resistance from thepatient tissue, for example. In at least one such instance, the jawopening rate and/or the jaw closing rate can be reduced once the jaws128040 and 128050 begin to experience force resistance above athreshold, for example.

In various instances, further to the above, the handle of the surgicalsystem 128000 comprises an actuator, the motion of which tracks, or issupposed to track, the motion of the jaws 128040 and 128050 of the endeffector 128030. For instance, the actuator can comprise a scissors-gripconfiguration which is openable and closable to mimic the opening andclosing of the end effector jaws 128040 and 128050. The control systemof the surgical system 128000 can comprise one or more sensor systemsconfigured to monitor the state of the end effector jaws 128040 and128050 and the state of the handle actuator and, if there is adiscrepancy between the two states, the control system can take acorrective action once the discrepancy exceeds a threshold and/orthreshold range. In at least one instance, the control system canprovide feedback, such as audio, tactile, and/or haptic feedback, forexample, to the clinician that the discrepancy exists and/or provide thedegree of discrepancy to the clinician. In such instances, the cliniciancan make mental compensations for this discrepancy. In addition to or inlieu of the above, the control system can adapt its control program ofthe jaws 128040 and 128050 to match the motion of the actuator. In atleast one instance, the control system can monitor the loading forcebeing applied to the jaws and align the closed position of the actuatorwith the position of the jaws when the jaws experience the peak forceloading condition when grasping tissue. Similarly, the control systemcan align the open position of the actuator with the position of thejaws when the jaws experience the minimum force loading condition whengrasping tissue. In various instances, the control system is configuredto provide the clinician with a control to override these adjustmentsand allow the clinician to use their own discretion in using thesurgical system 128000 in an appropriate manner.

A surgical system 128700 is illustrated in FIGS. 46 and 47 . Thesurgical system 128700 comprises a handle, a shaft assembly 128720extending from the handle, and an end effector 128730 extending from theshaft assembly 128720. In alternative embodiments, the surgical system128700 comprises a housing configured to be mounted to a roboticsurgical system. In at least one such embodiment, the shaft 128720extends from the robotic housing mount instead of the handle. In eitherevent, the end effector 128730 comprises shears configured to transectthe tissue of a patient. The shears comprise two jaws 128740 and 128750configured to transect the patient tissue positioned between the jaws128740 and 128750 as the jaws 128740 and 128750 are being closed. Eachof the jaws 128740 and 128750 comprises a sharp edge configured to cutthe tissue and are pivotably mounted to the shaft 128720 about a pivotjoint 128760. Such an arrangement can comprise bypassing scissorsshears. Other embodiments are envisioned in which one of the jaws 128740and 128750 comprises a knife edge and the other comprises a mandrelagainst the tissue is supported and transected. Such an arrangement cancomprise a knife wedge in which the knife wedge is moved toward themandrel. In at least one embodiment, the jaw comprising the knife edgeis movable and the jaw comprising the mandrel is stationary. The abovebeing said, embodiments are envisioned in which the tissue-engagingedges of one or both of the jaws 128740 and 128750 are not necessarilysharp.

As discussed above, the end effector 128730 comprises two scissor jaws128740 and 128750 movable between an open position and a closed positionto cut the tissue of a patient. The jaw 128740 comprises a sharp distalend 128741 and the jaw 128750 comprises a sharp distal end 128751 whichare configured to snip the tissue of the patient at the mouth 128731 ofthe end effector 128730, for example. That said, other embodiments areenvisioned in which the distal ends 128741 and 128751 are blunt and canbe used to dissect tissue, for example. In any event, the jaws aredriven by a jaw drive system including an electric drive motor, thespeed of which is adjustable to adjust the closure rate and/or openingrate of the jaws. Referring to the graph 128400 of FIG. 48 , the controlsystem of the surgical system is configured to monitor the loading, orshear, force on the jaws 128740 and 128750 as the jaws 128740 and 128750are being closed and adaptively slow down the drive motor when largeforces, or forces above a threshold Fc, are experienced by the jaws128740 and 128750. Such large forces often occur when the tissue T beingcut by the jaws 128740 and 128750 is thick, for example. Similar to theabove, the control system can monitor the current drawn by the drivemotor as a proxy for the loading force being experienced by the jaws128740 and 128750. In addition to or in lieu of this approach, thecontrol system can be configured to measure the jaw loading forcedirectly by one or more load cells and/or strain gauges, for example.Once the loading force experienced by the jaws 128740 and 128750 dropsbelow the force threshold Fc, the control system can adaptively speed upthe jaw closure rate. Alternatively, the control system can maintain thelower closure rate of the jaws 128740 and 128750 even though the forcethreshold is no longer being exceeded.

The above-provided discussion with respect to the surgical system 128700can provide mechanical energy or a mechanical cutting force to thetissue of a patient. That said, the surgical system 128700 is alsoconfigured to provide electrosurgical energy or an electrosurgicalcutting force to the tissue of a patient. In various instances, theelectrosurgical energy comprises RF energy, for example; however,electrosurgical energy could be supplied to the patient tissue at anysuitable frequency. In addition to or in lieu of AC power, the surgicalsystem 128700 can be configured to supply DC power to the patienttissue. The surgical system 128700 comprises a generator in electricalcommunication with one or more electrical pathways defined in theinstrument shaft 128720 which can supply electrical power to the jaws128740 and 128750 and also provide a return path for the current. In atleast one instance, the jaw 128740 comprises an electrode 128742 inelectrical communication with a first electrical pathway in the shaft128720 and the jaw 128750 comprises an electrode 128752 in electricalcommunication with a second electrical pathway in the shaft 128720. Thefirst and second electrical pathways are electrically insulated, or atleast substantially insulated, from one another and the surroundingshaft structure such that the first and second electrical pathways, theelectrodes 128742 and 128752, and the tissue positioned between theelectrodes 128742 and 128752 forms a circuit. Such an arrangementprovides a bipolar arrangement between the electrodes 128742 and 128752.That said, embodiments are envisioned in which a monopolar arrangementcould be used. In such an arrangement, the return path for the currentgoes through the patient and into a return electrode positioned on orunder the patient, for example.

As discussed above, the tissue of a patient can be cut by using amechanical force and/or an electrical force. Such mechanical andelectrical forces can be applied simultaneously and/or sequentially. Forinstance, both forces can be applied at the beginning of a tissuecutting actuation and then the mechanical force can be discontinued infavor of the electrosurgical force finishing the tissue cuttingactuation. Such an approach can apply an energy-created hemostatic sealto the tissue after the mechanical cutting has been completed. In sucharrangements, the electrosurgical force is applied throughout theduration of the tissue cutting actuation. In other instances, themechanical cutting force, without the electrosurgical cutting force, canbe used to start a tissue cutting actuation which is then followed bythe electrosurgical cutting force after the mechanical cutting force hasbeen stopped. In such arrangements, the mechanical and electrosurgicalforces are not overlapping or co-extensive. In various instances, boththe mechanical and electrosurgical forces are overlapping andco-extensive throughout the entire tissue cutting actuation. In at leastone instance, both forces are overlapping and co-extensive throughoutthe entire tissue cutting actuation but in magnitudes or intensitiesthat change during the tissue cutting actuation. The above being said,any suitable combination, pattern, and/or sequence of mechanical andelectrosurgical cutting forces and energies could be used.

Further to the above, the surgical system 128700 comprises a controlsystem configured to co-ordinate the application of the mechanical forceand electrosurgical energy to the patient tissue. In various instances,the control system is in communication with the motor controller whichdrives the jaws 128740 and 128750 and, also, the electrical generatorand comprises one or more sensing systems for monitoring the mechanicalforce and electrosurgical energy being applied to the tissue. Systemsfor monitoring the forces within a mechanical drive system are disclosedelsewhere herein. Systems for monitoring the electrosurgical energybeing applied to the patient tissue include monitoring the impedance, orchanges in the impedance, of the patient tissue via the electricalpathways of the electrosurgical circuit. In at least one instance,referring to the graph 128800 in FIG. 49 , the RF current/voltage ratioof the electrosurgical power being applied to the patient tissue by thegenerator is evaluated by monitoring the current and voltage of thepower being supplied by the generator. The impedance of the tissue andthe RF current/voltage ratio of the electrosurgical power are a functionof many variables such as the temperature of the tissue, the density ofthe tissue, the thickness of the tissue, the type of tissue between thejaws 128740 and 128750, the duration in which the power is applied tothe tissue, among others, which change throughout the application of theelectrosurgical energy.

Further to the above, the control system and/or generator of thesurgical system 128700 comprises one or more ammeter circuits and/orvoltmeter circuits configured to monitor the electrosurgical currentand/or voltage, respectively, being applied to the patient tissue.Referring again to FIG. 49 , a minimum amplitude limit and/or a maximumamplitude limit on the current being applied to the patient tissue canbe preset in the control system and/or can be controllable by the userof the surgical instrument system through one or more input controls.The minimum and maximum amplitude limits can define a current envelopewithin which the electrosurgical portion of the surgical system 128700is operated.

In various instances, the control system of the surgical system 128700is configured to adaptively increase the electrosurgical energy appliedto the patient tissue when the drive motor slows. The motor slowing canbe a reaction to an increase in the tissue cutting load and/or anadaptation of the control system. Similarly, the control system of thesurgical system 128700 is configured to adaptively increase theelectrosurgical energy applied to the patient tissue when the drivemotor stops. Again, the motor stopping can be a reaction to an increasein the tissue cutting load and/or an adaptation of the control system.Increasing the electrosurgical energy when the electric motor slowsand/or stops can compensate for a reduction in mechanical cuttingenergy. In alternative embodiments, the electrosurgical energy can bereduced and/or stopped when the electric motor slows and/or stops. Suchembodiments can afford the clinician to evaluate the situation in alow-energy environment.

In various instances, the control system of the surgical system 128700is configured to adaptively decrease the electrosurgical energy appliedto the patient tissue when the drive motor speeds up. The motor speedingup can be a reaction to a decrease in the cutting load and/or anadaptation of the control system. Decreasing the electrosurgical energywhen the electric motor slows and/or stops can compensate for, orbalance out, an increase in mechanical cutting energy. In alternativeembodiments, the electrosurgical energy can be increased when theelectric motor speeds up. Such embodiments can accelerate the closure ofthe jaws and provide a clean, quick cutting motion.

In various instances, the control system of the surgical system 128700is configured to adaptively increase the speed of the drive motor whenthe electrosurgical energy applied to the patient tissue decreases. Theelectrosurgical energy decreasing can be a reaction to a change intissue properties and/or an adaptation of the control system. Similarly,the control system of the surgical system 128700 is configured toadaptively increase the speed of the drive motor when electrosurgicalenergy applied to the patient tissue stops in response to an adaptationof the control system. Increasing the speed of the drive motor when theelectrosurgical energy decreases or is stopped can compensate for areduction in electrosurgical cutting energy. In alternative embodiments,the speed of the drive motor can be reduced and/or stopped when theelectrosurgical energy decreases and/or is stopped. Such embodiments canafford the clinician to evaluate the situation in a low-energy and/orstatic environment.

In various instances, the control system of the surgical system 128700is configured to adaptively decrease the speed of the electric motorwhen the electrosurgical energy applied to the patient tissue increases.The electrosurgical energy increasing can be a reaction to a change intissue properties and/or an adaptation of the control system. Decreasingthe drive motor speed when the electrosurgical energy increases cancompensate for, or balance out, an increase in electrosurgical cuttingenergy. In alternative embodiments, the drive motor speed can beincreased when the electrosurgical energy increases. Such embodimentscan accelerate the closure of the jaws and provide a clean, quickcutting motion.

In various instances, the surgical system 128700 comprises controls,such as on the handle of the surgical system 128700, for example, that aclinician can use to control when the mechanical and/or electrosurgicalforces are applied. In addition to or in lieu of manual controls, thecontrol system of the surgical system 128700 is configured to monitorthe mechanical force and electrical energy being applied to the tissueand adjust one or the other, if needed, to cut the tissue in a desirablemanner according to one or more predetermined force-energy curves and/ormatrices. In at least one instance, the control system can increase theelectrical energy being delivered to the tissue once the mechanicalforce being applied reaches a threshold limit. Moreover, the controlsystem is configured to consider other parameters, such as the impedanceof the tissue being cut, when making adjustments to the mechanical forceand/or electrical energy being applied to the tissue.

FIG. 50 is a logic diagram of a control system 75000 for use with any ofthe various suturing instruments described herein. The control system75000 comprises a control circuit. The control circuit includes amicrocontroller 75040 comprising a processor 75020 and a memory 75030.One or more sensors, such as sensor 75080, sensor 75090, sensor 71502,and sensor array 71940, for example, provide real time feedback to theprocessor 75020. The control system 75000 further comprises a motordriver 75050 configured to control an electric motor 75010 and atracking system 75060 configured to determine the position of one ormore movable components in the suturing instruments, such as a needle,needle drive system, suture, and/or suture spool, for example. Thetracking system 75060 provides position information to the processor75020, which can be programmed or configured to, among other things,determine the position of the suture needle, for example. The motordriver 75050 may be an A3941 available from Allegro Microsystems, Inc.,for example; however, other motor drivers may be readily substituted foruse in the tracking system 75060. A detailed description of an absolutepositioning system is described in U.S. Patent Application PublicationNo. 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING ASURGICAL STAPLING AND CUTTING INSTRUMENT, the entire disclosure of whichis hereby incorporated herein by reference.

The microcontroller 75040 may be any single core or multicore processorsuch as those known under the trade name ARM Cortex by TexasInstruments, for example. In at least one instance, the microcontroller75040 is a LM4F230H5QR ARM Cortex-M4F Processor Core, available fromTexas Instruments, for example, comprising on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle serial random access memory (SRAM), internal read-onlymemory (ROM) loaded with StellarisWare® software, 2 KB electricallyerasable programmable read-only memory (EEPROM), one or more pulse widthmodulation (PWM) modules and/or frequency modulation (FM) modules, oneor more quadrature encoder inputs (QEI) analog, one or more 12-bitAnalog-to-Digital Converters (ADC) with 12 analog input channels, forexample, details of which are available from the product datasheet.

In various instances, the microcontroller 75040 comprises a safetycontroller comprising two controller-based families such as TMS570 andRM4x known under the trade name Hercules ARM Cortex R4, also by TexasInstruments. The safety controller may be configured specifically forIEC 61508 and ISO 26262 safety critical applications, among others, toprovide advanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 75040 is programmed to perform various functionssuch as precisely controlling the speed and/or position of the sutureneedle, for example. The microcontroller 75040 is also programmed toprecisely control the rotational speed and position of the end effectorof the suturing instrument and the articulation speed and position ofthe end effector of the suturing instrument. In various instances, themicrocontroller 75040 computes a response in the software of themicrocontroller 75040. The computed response is compared to a measuredresponse of the actual system to obtain an “observed” response, which isused for actual feedback decisions. The observed response is afavorable, tuned, value that balances the smooth, continuous nature ofthe simulated response with the measured response, which can detectoutside influences on the system.

The motor 75010 is controlled by the motor driver 75050. In variousforms, the motor 75010 is a DC brushed driving motor having a maximumrotational speed of approximately 25,000 RPM, for example. In otherarrangements, the motor 75010 includes a brushless motor, a cordlessmotor, a synchronous motor, a stepper motor, or any other suitableelectric motor. The motor driver 75050 may comprise an H-bridge drivercomprising field-effect transistors (FETs), for example. The motordriver 75050 may be an A3941 available from Allegro Microsystems, Inc.,for example. The A3941 motor driver 75050 is a full-bridge controllerfor use with external N-channel power metal oxide semiconductor fieldeffect transistors (MOSFETs) specifically designed for inductive loads,such as brush DC motors. In various instances, the motor driver 75050comprises a unique charge pump regulator provides full (>10 V) gatedrive for battery voltages down to 7 V and allows the A3941 motor driver75050 to operate with a reduced gate drive, down to 5.5 V. A bootstrapcapacitor may be employed to provide the above-battery supply voltagerequired for N-channel MOSFETs. An internal charge pump for thehigh-side drive allows DC (100% duty cycle) operation. The full bridgecan be driven in fast or slow decay modes using diode or synchronousrectification. In the slow decay mode, current recirculation can bethrough the high-side or the lowside FETs. The power FETs are protectedfrom shoot-through by resistor adjustable dead time. Integrateddiagnostics provide indication of undervoltage, overtemperature, andpower bridge faults, and can be configured to protect the power MOSFETsunder most short circuit conditions. Other motor drivers may be readilysubstituted.

The tracking system 75060 comprises a controlled motor drive circuitarrangement comprising one or more position sensors, such as the sensor75080, sensor 75090, sensor 71502, and sensory array 71940, for example.The position sensors for an absolute positioning system provide a uniqueposition signal corresponding to the location of a displacement member.As used herein, the term displacement member is used generically torefer to any movable member of any of the surgical instruments disclosedherein. In various instances, the displacement member may be coupled toany position sensor suitable for measuring linear displacement orrotational displacement. Linear displacement sensors may include contactor non-contact displacement sensors. The displacement sensors maycomprise linear variable differential transformers (LVDT), differentialvariable reluctance transducers (DVRT), a slide potentiometer, amagnetic sensing system comprising a movable magnet and a series oflinearly arranged Hall Effect sensors, a magnetic sensing systemcomprising a fixed magnet and a series of movable linearly arranged HallEffect sensors, an optical sensing system comprising a movable lightsource and a series of linearly arranged photo diodes or photodetectors, or an optical sensing system comprising a fixed light sourceand a series of movable linearly arranged photo diodes or photodetectors, or any combination thereof.

The position sensors 75080, 75090, 71502, and 71940 for example, maycomprise any number of magnetic sensing elements, such as, for example,magnetic sensors classified according to whether they measure the totalmagnetic field or the vector components of the magnetic field. Thetechniques used to produce both types of magnetic sensors encompass manyaspects of physics and electronics. The technologies used for magneticfield sensing include search coil, fluxgate, optically pumped, nuclearprecession, SQUID, Hall-Effect, anisotropic magnetoresistance, giantmagnetoresistance, magnetic tunnel junctions, giant magnetoimpedance,magnetostrictive/piezoelectric composites, magnetodiode,magnetotransistor, fiber optic, magnetooptic, and microelectromechanicalsystems-based magnetic sensors, among others.

In various instances, one or more of the position sensors of thetracking system 75060 comprise a magnetic rotary absolute positioningsystem. Such position sensors may be implemented as an AS5055EQFTsingle-chip magnetic rotary position sensor available from AustriaMicrosystems, AG and can be interfaced with the controller 75040 toprovide an absolute positioning system. In certain instances, a positionsensor comprises a low-voltage and low-power component and includes fourHall-Effect elements in an area of the position sensor that is locatedadjacent a magnet. A high resolution ADC and a smart power managementcontroller are also provided on the chip. A CORDIC processor (forCoordinate Rotation Digital Computer), also known as the digit-by-digitmethod and Volder's algorithm, is provided to implement a simple andefficient algorithm to calculate hyperbolic and trigonometric functionsthat require only addition, subtraction, bitshift, and table lookupoperations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface such as an SPI interface to the controller 75040. The positionsensors can provide 12 or 14 bits of resolution, for example. Theposition sensors can be an AS5055 chip provided in a small QFN 16-pin4×4×0.85 mm package, for example.

The tracking system 75060 may comprise and/or be programmed to implementa feedback controller, such as a PID, state feedback, and adaptivecontroller. A power source converts the signal from the feedbackcontroller into a physical input to the system, in this case voltage.Other examples include pulse width modulation (PWM) and/or frequencymodulation (FM) of the voltage, current, and force. Other sensor(s) maybe provided to measure physical parameters of the physical system inaddition to position. In various instances, the other sensor(s) caninclude sensor arrangements such as those described in U.S. Pat. No.9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which is hereby incorporated herein by reference in its entirety; U.S.Patent Application Publication No. 2014/0263552, entitled STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporatedherein by reference in its entirety; and U.S. patent application Ser.No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTORVELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, which is herebyincorporated herein by reference in its entirety. In a digital signalprocessing system, absolute positioning system is coupled to a digitaldata acquisition system where the output of the absolute positioningsystem will have finite resolution and sampling frequency. The absolutepositioning system may comprise a compare and combine circuit to combinea computed response with a measured response using algorithms such asweighted average and theoretical control loop that drives the computedresponse towards the measured response. The computed response of thephysical system takes into account properties like mass, inertial,viscous friction, inductance resistance, etc., to predict what thestates and outputs of the physical system will be by knowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power up of the instrument without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 75010 has takento infer the position of a device actuator, the needle driver, and thelike.

A sensor 75080 and/or 71502 comprising a strain gauge or a micro-straingauge, for example, is configured to measure one or more parameters ofthe end effector of the suturing instrument, such as, for example, thestrain experienced by the needle during a suturing operation. Themeasured strain is converted to a digital signal and provided to theprocessor 75020. A sensor 75090 comprising a load sensor, for example,can measure another force applied by the suturing instrument. In variousinstances, a current sensor 75070 can be employed to measure the currentdrawn by the motor 75010. The force required to throw, or rotate, thesuturing needle can correspond to the current drawn by the motor 75010,for example. The measured force is converted to a digital signal andprovided to the processor 75020. A magnetic field sensor can be employedto measure the thickness of the captured tissue. The measurement of themagnetic field sensor can also be converted to a digital signal andprovided to the processor 75020.

The measurements of the tissue thickness and/or the force required torotate the needle through tissue as measured by the sensors can be usedby the controller 75040 to characterize the position and/or speed of themovable member being tracked. In at least one instance, the memory 75030may store a technique, an equation, and/or a look-up table which can beemployed by the controller 75040 in the assessment. In variousinstances, the controller 75040 can provide the user of the suturinginstrument with a choice as to the manner in which the suturinginstrument should be operated. To this end, a display 75044 can displaya variety of operating conditions of the suturing instrument and caninclude touch screen functionality for data input. Moreover, informationdisplayed on the display 75044 may be overlaid with images acquired viathe imaging modules of one or more endoscopes and/or one or moreadditional surgical instruments used during the surgical procedure.

As discussed above, the suturing instruments disclosed herein maycomprise control systems. Each of the control systems can comprise acircuit board having one or more processors and/or memory devices. Amongother things, the control systems are configured to store sensor data,for example. They are also configured to store data which identifies thetype of suturing instrument attached to a handle or housing. Morespecifically, the type of suturing instrument can be identified whenattached to the handle or housing by the sensors and the sensor data canbe stored in the control system. Moreover, they are also configured tostore data including whether or not the suturing instrument has beenpreviously used and/or how many times the suture needle has been cycled.This information can be obtained by the control system to assess whetheror not the suturing instrument is suitable for use and/or has been usedless than a predetermined number of times, for example.

Example Set 1 Example 1

A surgical suturing system comprising a firing system and an endeffector comprising a needle track, a needle comprising suturingmaterial attached thereto, wherein the needle is configured to be guidedby and movable within the needle track, and wherein the firing system isconfigured to apply control motions to the needle to advance the needlethrough a firing stroke to suture tissue with the suturing material, andmeans for detecting a parameter of the needle during the firing stroke,wherein the surgical suturing system is configured to automaticallyadjust the control motions applied to the needle based on the detectedparameter.

Example 2

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector comprising a flexibleneedle comprising suturing material attached thereto, wherein the firingdrive is configured to apply control motions to the needle to advancethe needle through a firing stroke to suture tissue with the suturingmaterial, and wherein the flexible needle comprises a first end and asecond end, and a movable needle guide, wherein the movable needle guideis movable between, one, a collapsed configuration for passing the endeffector through a trocar, wherein, in the collapsed configuration, theend effector comprises a collapsed diameter which is less than or equalto the shaft diameter, and wherein the first end of the flexible needleis oriented proximal to the second end in the collapsed configurationand, two, an expanded configuration for suturing tissue with theflexible needle, wherein, in the expanded configuration, the endeffector comprises an expanded diameter which is greater than the shaftdiameter, and wherein the flexible is configured to be advanced throughits firing stroke when the movable need guide is in the expandedconfiguration.

Example 3

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector extending distally fromthe shaft, wherein the end effector comprises a needle track and aneedle comprising suturing material attached thereto, wherein the needleis configured to be guided by the needle track and actuated by thefiring drive, and wherein the needle is movable along a needle pathcomprising a maximum capture width which is greater than the shaftdiameter.

Example 4

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector extending distally fromthe shaft, wherein the end effector comprises a needle track comprisinga linear section and a needle comprising a linear segment, an arcuatesegment extending from the linear segment, and suturing materialattached to the needle, wherein the needle is configured to be guided bythe needle track and actuated by the firing drive, and wherein thefiring drive is configured to rotate the needle and displace the needlelinearly to move the needle along a continuous loop stroke.

Example 5

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle track and a needle comprising suturing materialattached thereto, wherein the needle is configured to be guided by theneedle track and actuated by the firing drive through a firing stroke tosuture tissue. The surgical suturing system further comprises means fordetecting a load experienced by the needle during the firing stroke andmeans for monitoring the detected load, wherein the surgical suturingsystem is configured to initiate a change in the operation of thesurgical suturing system when the load exceeds a predeterminedthreshold.

Example 6

A modular surgical instrument comprising a control interface, a shaftextending from the control interface, a drive system, and means fordetecting electrical potential applied to the modular surgicalinstrument, wherein the modular surgical instrument is configured toautomatically initiate a change in operation of the modular surgicalinstrument when the detected electrical potential exceeds apredetermined threshold.

Example 7

A surgical suturing cartridge comprising a needle movable through afiring stroke, wherein the firing stroke comprises a home position, apartially fired position, and a fully actuated position, wherein theneedle moves along a path in a single direction from the home positionto the fully actuated position and from the fully actuated position tothe home position during a full firing stroke. The surgical suturingcartridge further comprises a sensing circuit comprising a supplyconductor comprising a first resistive leg, wherein the first resistiveleg terminates at a first terminal and comprises a first resistance, anda return conductor comprising a second resistive leg terminating at asecond terminal and comprising a second resistance and a third resistiveleg terminating at a third terminal and comprising a third resistance,wherein the first resistance, the second resistance, and the thirdresistance are different, and wherein the first resistive leg and thesecond resistive leg are wired in parallel with respect to the returnconductor. The needle is movable through the firing stroke to contactthe first terminal, the second terminal, and the third terminal in thehome position of the firing stroke, the second terminal and the thirdterminal in a partially fired position of the firing stroke, and thefirst terminal and the third terminal in a fully fired positon of thefiring stroke. The surgical suturing cartridge further comprises meansfor monitoring the resistance of the sensing circuit during the firingstroke, wherein the sensing circuit comprises a first circuit resistancewhen the needle is in the home position, a second circuit resistancewhen the needle is in the partially fired position, and a third circuitresistance when the needle is in the fully fired position, wherein thefirst circuit resistance, the second circuit resistance, and the thirdcircuit resistance are different, and wherein the resistance of thesensing circuit indicates the position of the needle during the firingstroke.

Example 8

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle track and a needle comprising suturing materialattached thereto, wherein the needle is configured to be guided by theneedle track and actuated by the firing drive through a firing stroke tosuture tissue. The surgical suturing system further comprises aproximity sensor configured to sense movement of the needle during itsfiring stroke to indicate the position of the needle to a controlprogram of the surgical suturing system.

Example 9

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track, and a needle comprising suturing material attachedthereto, wherein the needle is configured to be guided by the needletrack and actuated by the needle driver through a firing stroke tosuture tissue. The surgical suturing system further comprises aproximity sensor configured to sense movement of the needle driver asthe needle driver advances the needle through the firing stroke toindicate the position of the needle driver to a control program of thesurgical suturing system.

Example 10

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track, and a needle comprising suturing material attachedthereto, wherein the needle is configured to be guided by the needletrack and actuated by the needle driver through a firing stroke tosuture tissue. The surgical suturing system further comprises a positionsensing system comprising a magnet and a Hall Effect sensor, wherein theneedle is configured to interrupt a magnetic field induced by the magnetto change the condition of the Hall Effect sensor to indicate theposition of the needle driver to a control program of the surgicalsuturing system.

Example 11

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track comprising a first wall and a second wall, and a needlecomprising suturing material attached thereto, wherein the needle isconfigured to be guided by the needle track and actuated by the needledriver through a firing stroke to suture tissue. The surgical suturingsystem further comprises a position sensing circuit comprising a firstconductor connected to the first wall of the track and a secondconductor connected to the second wall of the track, wherein the needleis configured to move into and out of contact with the first wall andthe second wall as the needle is moved through the firing stroke toindicate the position of the needle.

Example 12

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track comprising a first wall and a second wall, and a needlecomprising suturing material attached thereto, wherein the needle isconfigured to be guided by the needle track and actuated by the needledriver through a firing stroke to suture tissue. The surgical suturingsystem further comprises a position sensing flex circuit comprising afirst conductor comprising a first terminal folded over and adhered tothe first wall of the track and a second conductor comprising a secondterminal folded over and adhered to the second wall of the track,wherein the needle is configured to move into and out of contact withthe first terminal and the second terminal as the needle is movedthrough the firing stroke to indicate the position of the needle.

Example 13

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track comprising a first wall and a second wall, and a needlecomprising suturing material attached thereto, wherein the needle isconfigured to be guided by the needle track and actuated by the needledriver through a firing stroke to suture tissue. The surgical suturingsystem further comprises a position sensing circuit comprising a firstconductor comprising a first terminal molded into to the first wall ofthe track and a second conductor comprising a second terminal moldedinto to the second wall of the track, wherein the needle is configuredto move into and out of contact with the first terminal and the secondterminal as the needle is moved through the firing stroke to indicatethe position of the needle.

Example 14

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,a needle track comprising a first wall and a second wall, and a needlecomprising suturing material attached thereto, wherein the needle isconfigured to be guided by the needle track and actuated by the needledriver through a firing stroke to suture tissue. The surgical suturingsystem further comprises a position sensing system comprising aninfrared LED emitter, and a photodetector configured to detect infraredlight emitted by the infrared LED emitter, wherein the needle isconfigured to interrupt the infrared light emitted by the infrared LEDemitter as the needle is moved through the firing stroke to indicate theposition of the needle.

Example 15

A surgical suturing system comprising a shaft, a firing drive, and anend effector attached to the shaft, wherein the end effector comprises aneedle configured to be driven by the firing drive, a needle trackconfigured to guide the needle through a firing stroke, and suturingmaterial attached to the needle. The surgical suturing system furthercomprises a plurality of proximity sensors configured to detect theposition of the needle as the needle is advanced through the firingstroke, wherein the plurality of proximity sensors are positioned suchthat the needle is configured to trip at least two of the plurality ofproximity sensors at all times during the firing stroke, wherein thesurgical suturing system is configured to determine if the needle hasdiverted from the needle track if less than two of the proximity sensorsare tripped at any point during the firing stroke.

Example 16

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector attached to the shaft,wherein the end effector comprises a needle driver configured to beactuated by the firing drive, a needle track, a needle comprisingsuturing material attached thereto, wherein the needle is configured tobe guided by the needle track and actuated by the needle driver througha firing stroke to suture tissue, and a tissue bite region where theneedle is configured to be advanced through the tissue bite region tosuture tissue, wherein the tissue bite region comprises a width greaterthan the shaft diameter. The end effector is movable relative to theshaft such that the tissue bite region can extend beyond the shaftdiameter.

Example 17

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle track comprising a linear section and a needlecomprising a linear segment, an arcuate segment extending from thelinear segment, and suturing material attached to the needle, whereinthe needle is configured to be guided by the needle track and actuatedby the firing drive, wherein the firing drive is configured to rotatethe needle and displace the needle linearly to move the needlethroughout a needle firing stroke, and wherein the needle firing strokecan be varied from stroke to stroke.

Example 18

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a circular needle comprising a first end and a second endhelically extending at least 360 degrees from the first end, wherein thefirst end and the second end define a vertical distance therebetween.The end effector further comprises suturing material attached to thecircular needle, wherein the circular needle is configured to beactuated through a helical drive stroke to suture tissue.

Example 19

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a helical needle and suturing material attached to the helicalneedle, wherein the helical needle is configured to be driven through athree dimensional needle stroke by the firing drive to suture tissue.

Example 20

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,wherein the needle driver is configured to drive a needle installedwithin the end effector, and a needle track configured to guide theneedle installed within the end effector through a needle firing stroke.The end effector is configured to receive suturing needles havingdifferent circumference lengths, and wherein the surgical suturingsystem is configured to adjust the actuation of the needle driver toaccommodate needles with different circumference lengths installedwithin the end effector.

Example 21

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver configured to be actuated by the firing drive,wherein the needle driver is configured to drive a needle installedwithin the end effector, and a needle track configured to guide theneedle installed within the end effector through a needle firing stroke.The end effector is configured to receive suturing needles havingdifferent diameters, and wherein the surgical suturing system isconfigured to adjust the actuation speed of the needle driver toaccommodate needles with different diameters installed within the endeffector.

Example 22

A surgical suturing system comprising an actuation interface comprisinga motor, an attachment interface, and an output drive configured to bedriven by the motor. The surgical suturing system further comprises amodular attachment configured to be attached to and detached from theactuation interface, wherein the modular attachment comprises a shaft,an input drive configured to be coupled with the output drive upon theattachment of the modular attachment and the actuation interface, and anend effector extending distally from the shaft. The surgical suturingsystem further comprises a load sensor configured to detect the loadapplied to the input drive and the output drive when the input drive andthe output drive are actuated by the motor, wherein the surgicalsuturing system is configured to limit current flow through the motorwhen the detected load reaches a first threshold, and wherein thesurgical suturing system is configured to shut off the motor when thedetected load falls below a second threshold.

Example 23

A surgical suturing system comprising an actuation interface comprisinga motor, an attachment interface, and an output drive configured to bedriven by the motor. The surgical suturing system further comprises amodular attachment configured to be attached to and detached from theactuation interface, wherein the modular attachment comprises a shaft,an input drive configured to be coupled with the output drive upon theattachment of the modular attachment and the actuation interface, and anend effector extending distally from the shaft. The surgical suturingsystem further comprises a load sensor configured to detect the loadapplied to the input drive and the output drive when the input drive andthe output drive are actuated by the motor, wherein the surgicalsuturing system is configured to limit power to the motor when thedetected load reaches a first threshold, and wherein the surgicalsuturing system is configured to stop power to the motor when thedetected load falls below a second threshold.

Example 24

A surgical instrument comprising a motor, a drive system configured tobe actuated by the motor, and a shaft. The surgical instrument furthercomprises an articulation joint, an end effector attached to the shaftby way of the articulation joint, wherein the end effector is configuredto be articulated relative to the shaft by the drive system, and amonitoring system configured to monitor electrical energy applied to thesurgical instrument, wherein the surgical instrument is configured toreverse the actuation of the motor when an unexpected electrical energyis detected.

Example 25

A surgical instrument comprising a motor, a drive system configured tobe actuated by the motor, and a shaft. The surgical instrument furthercomprises an articulation joint, an end effector attached to the shaftby way of the articulation joint, wherein the end effector is configuredto be articulated relative to the shaft by the drive system, and amonitoring system configured to monitor electrical energy applied to thesurgical instrument, wherein the surgical instrument is configured topause actuation of the motor when an unexpected electrical energy isdetected and indicate to a user the condition of the surgicalinstrument.

Example 26

A surgical instrument comprising a motor, a drive system configured tobe actuated by the motor, and a shaft. The surgical instrument furthercomprises an end effector attached to the shaft and a strain gaugemounted to the shaft, wherein the surgical instrument is configured toindicate to a user the strain detected by the strain gauge to indicateforce being applied to tissue with the shaft.

Example 27

A surgical suturing system comprising a first motor, a second motor, ashaft, and an end effector attached to the shaft, wherein the endeffector comprises a longitudinal axis, wherein the second motor isconfigured to rotate the end effector about the longitudinal axis, aneedle configured to be driven through a firing stroke by the firstmotor, and suturing material attached to the needle. The surgicalsuturing system further comprises a first sensor configured to senseforce experienced by the needle as the needle is advanced through thefiring stroke, a second sensor configured to sense load torqueexperienced by the end effector as the end effector is rotated about thelongitudinal axis, a third sensor configured to sense bending loadexperienced by the shaft and a control program configured to monitor theforce experienced by the needle such that, if the force experienced bythe needle exceeds a first predetermined threshold, the control programlimits the current flow through the first motor, monitor the load torqueexperienced by the end effector such that, if the load torqueexperienced by the end effector exceeds a second predeterminedthreshold, the control program limits the current flow through thesecond motor, and monitor the bending load experienced by the shaft suchthat, if the load bending load experienced by the shaft exceeds a thirdpredetermined threshold, the control program reduces the current flowthrough the second motor.

Example 28

A surgical instrument configured to apply a suture to the tissue of apatient comprising an end effector comprising a replaceable suturecartridge comprising a suture removably stored therein, an actuatorconfigured to deploy the suture, and a lockout configurable in a lockedconfiguration and an unlocked configuration, wherein the lockout is inthe locked configuration when the replaceable suture cartridge is not inthe end effector, wherein the lockout prevents the actuator from beingactuated when the lockout is in the locked configuration, wherein thelockout is in the unlocked configuration when the replaceable suturecartridge is positioned in the end effector, and wherein the lockoutpermits the actuator to deploy the suture when the lockout is in theunlocked configuration. The surgical instrument further comprises ahandle, an electric motor configured to drive the actuator, a controlcircuit configured to control the electric motor, and a sensing systemconfigured to determine when the lockout is in the locked configuration,wherein the sensing system is in communication with the control circuit,and wherein the control circuit prevents the actuation of the electricmotor when the sensing system determines that the lockout is in thelocked configuration.

Example 29

A surgical instrument configured to apply a suture to the tissue of apatient comprising an end effector. The end effector comprises areplaceable suture cartridge comprising a suture removably storedtherein, an actuator configured to deploy the suture, and a lockoutconfigurable in a locked configuration and an unlocked configuration,wherein the lockout is in the locked configuration when the replaceablesuture cartridge is not in the end effector, wherein the lockoutprevents the actuator from being actuated when the lockout is in thelocked configuration, wherein the lockout is in the unlockedconfiguration when the replaceable suture cartridge is positioned in theend effector, and wherein the lockout permits the actuator to deploy thesuture when the lockout is in the unlocked configuration. The surgicalinstrument further comprises a handle, an electric motor configured todrive the actuator, a control circuit configured to control the electricmotor, and a sensing system configured to determine when the lockout isin the locked configuration, wherein the sensing system is incommunication with the control circuit, and wherein the control circuitprovides haptic feedback to the user of the surgical instrument when thesensing system determines that the lockout is in the lockedconfiguration.

Example 30

A surgical instrument configured to apply a suture to the tissue of apatient comprising an end effector. The end effector comprises areplaceable suture cartridge comprising a suture removably storedtherein, an actuator configured to deploy the suture, and a lockoutconfigurable in a locked configuration and an unlocked configuration,wherein the lockout is in the locked configuration when the replaceablesuture cartridge has been completely expended, wherein the lockoutprevents the actuator from being actuated when the lockout is in thelocked configuration, wherein the lockout is in the unlockedconfiguration when the replaceable suture cartridge is positioned in theend effector and has not been completely expended, and wherein thelockout permits the actuator to deploy the suture when the lockout is inthe unlocked configuration. The surgical instrument further comprises ahandle, an electric motor configured to drive the actuator, a controlcircuit configured to control the electric motor, and a sensing systemconfigured to determine when the lockout is in the locked configuration,wherein the sensing system is in communication with the control circuit,and wherein the control circuit prevents the actuation of the electricmotor when the sensing system determines that the lockout is in theconfiguration.

Example Set 2 Example 1

A surgical dissector for manipulating the tissue of a patient comprisinga shaft comprising an electrical pathway and a first jaw pivotablycoupled to the shaft. The first jaw comprises a first inner surface, afirst outer surface comprising a first opening, wherein the first outersurface faces away from the first inner surface, a firstelectrically-conductive portion in electrical communication with theelectrical pathway, wherein the first electrically-conductive portioncan contact the tissue through the first opening, and a firstelectrically-insulative portion. The surgical dissector furthercomprises a second jaw pivotably coupled to the shaft, wherein thesecond jaw comprises a second inner surface, wherein the second innersurface faces toward the first inner surface, a second outer surfacecomprising a second opening, wherein the second outer surface faces awayfrom the second inner surface, a second electrically conductive portionin electrical communication with the electrical pathway, wherein thesecond electrically-conductive portion can contact the tissue throughthe second opening, and a second electrically-insulative portion.

Example 2

The surgical dissector of Example 1, further comprising a drive systemoperably coupled with the first jaw and the second jaw, wherein thedrive system comprises an electric motor configured to drive the firstjaw and the second jaw from a closed position into an open position.

Example 3

The surgical dissector of Example 2, further comprising a handlecomprising a grip, wherein the electric motor is position in the handle.

Example 4

The surgical dissector of Examples 2 or 3, further comprising a housingconfigured to be attached to a robotic surgical system, wherein theelectric motor is position in the robotic surgical system.

Example 5

The surgical dissector of Examples 2, 3, or 4, further comprising acontrol system in communication with the electric motor and theelectrical pathway, wherein the control system is configured to controlthe electrical power supplied to the motor and the electrical pathway.

Example 6

The surgical dissector of Example 5, wherein the control systemcomprises a pulse width modulation motor control circuit configured tocontrol the speed of the electric motor.

Example 7

The surgical dissector of Examples 5 or 6, wherein the control systemcomprises at least one of a voltage regulation circuit and a currentregulation circuit configured to control the electrical power suppliedto the electrical pathway.

Example 8

The surgical dissector of Examples 5, 6, or 7 wherein the control systemis configured to control the voltage potential applied to the electricalpathway to control the electrical power applied to the patient tissue.

Example 9

The surgical dissector of Examples 5, 6, 7, or 8, wherein the controlsystem comprises an AC voltage control circuit configured to control thevoltage potential applied to the electrical pathway to control theelectrical power applied to the patient tissue.

Example 10

The surgical dissector of Example 5, 6, 7, 8, or 9, wherein the controlsystem comprises a DC voltage control circuit configured to control thevoltage potential applied to the electrical pathway to control theelectrical power applied to the patient tissue.

Example 11

The surgical dissector of Examples 5, 6, 7, 8, 9, or 10, wherein thecontrol system comprises a current control circuit configured to controlthe electrical power applied to the patient tissue.

Example 12

The surgical dissector of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11,further comprising a drive system operably coupled with the first jawand the second jaw, wherein the drive system comprises an electric motorconfigured to drive the first jaw and the second jaw from an openposition into a closed position.

Example 13

A surgical dissector for manipulating the tissue of a patient comprisinga shaft comprising an electrical pathway and a first jaw pivotablycoupled to the shaft. The first jaw comprises an inner surface, an outersurface comprising an opening, an electrically-conductive electrode inelectrical communication with the electrical pathway, wherein theelectrically-conductive electrode can contact the tissue through theopening, and an electrically-insulative portion. The surgical dissectorfurther comprises a second jaw pivotably coupled to the shaft.

Example 14

The surgical dissector of Example 14, further comprising a drive systemoperably coupled with the first jaw and the second jaw, wherein thedrive system comprises an electric motor configured to drive the firstjaw and the second jaw from a closed position into an open position.

Example 15

The surgical dissector of Examples 14 or 15, further comprising acontrol system in communication with the electric motor and theelectrical pathway, wherein he control system is configured to controlthe electrical power supplied to the electric motor and the electricalpathway.

Example 16

The surgical dissector of Example 15, wherein the control systemcomprises a pulse width modulation motor control circuit configured tocontrol the speed of the electric motor.

Example 17

The surgical dissector of Examples 15 or 16, wherein the control systemcomprises at least one of a voltage regulation circuit and a currentregulation circuit configured to control the electrical power suppliedto the electrical pathway.

Example 18

The surgical dissector of Examples 15, 16, or 17, wherein the controlsystem comprises an AC voltage control circuit configured to control thevoltage potential applied to the electrical pathway to control theelectrical power applied to the patient tissue.

Example 19

The surgical dissector of Examples 15, 16, 17, or 18, wherein thecontrol system comprises a current control circuit configured to controlthe electrical power applied to the patient tissue.

Example 20

A surgical dissector for manipulating the tissue of a patient comprisinga shaft comprising an electrical pathway, a first jaw pivotably coupledto the shaft, wherein the first jaw comprises an inner surface, an outersurface comprising an opening, an electrically-conductive electrode inelectrical communication with the electrical pathway, wherein theelectrically-conductive electrode can contact the tissue through theopening, and an electrically-insulative portion. The surgical dissectorfurther comprises a second jaw pivotably coupled to the shaft and meansfor spreading the first jaw and the second jaw and applying electricalenergy to the patient tissue at the same time.

Example Set 3 Example 1

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle driver, wherein the firing drive is configured toapply control motions to the needle driver, a needle track, and a needlecomprising suturing material attached thereto, wherein the needle isconfigured to be guided by the needle track and actuated by the needledriver through a firing stroke to suture tissue. The surgical suturingsystem further comprises a position sensing circuit comprising adetectable parameter, wherein the needle is configured to vary thedetectable parameter of the positioning sensing circuit as the needle isadvanced through the firing stroke, wherein the surgical suturing systemis configured to monitor the detectable parameter of the positionsensing circuit and automatically adjust the control motions applied tothe needle driver based on the detected parameter.

Example 2

The surgical suturing system of Example 1, wherein the position sensingsystem comprises an infrared LED emitter and a photodetector configuredto detect infrared light emitted by the infrared LED emitter, whereinthe needle is configured to interrupt the infrared light emitted by theinfrared LED emitter as the needle is moved through the firing stroke toindicate the position of the needle.

Example 3

The surgical suturing system of Example 2, wherein the needle trackcomprises an exit location where the needle exits the needle track andan entry location where the needle reenters the needle track, andwherein the infrared LED emitter is positioned at the exit location.

Example 4

The surgical suturing system of Examples 1, 2, or 3, wherein thedetectable parameter comprises a load experienced by the needle duringthe firing stroke.

Example 5

The surgical suturing system of Example 4, wherein the surgical suturingsystem is configured to adjust the control motions when the load exceedsa predetermined threshold.

Example 6

The surgical suturing system of Examples 1, 2, 3, 4, or 5, wherein theposition sensing system comprises a plurality of proximity sensorsconfigured to detect the position of the needle as the needle isadvanced through the firing stroke.

Example 7

The surgical suturing system of Example 6, wherein the plurality ofproximity sensors are positioned such that the needle is configured totrip at least two of the plurality of proximity sensors at all timesduring the firing stroke, and wherein the surgical suturing system isconfigured to determine if the needle has diverted from the needle trackif less than two of the proximity sensors are tripped at any pointduring the firing stroke.

Example 8

The surgical suturing system of Examples 1, 2, 3, 4, 5, 6, or 7, whereinthe position sensing system comprises a magnet and a Hall Effect sensor,wherein the needle is configured to interrupt a magnetic field inducedby the magnet to change the condition of the Hall Effect sensor toindicate the position of the needle driver to a control program of thesurgical suturing system.

Example 9

The surgical suturing system of Examples 1, 2, 3, 4, 5, 6, 7, or 8,wherein the position sensing system comprises a proximity sensorconfigured to sense movement of the needle driver as the needle driveradvances the needle through the firing stroke to indicate the positionof the needle driver to a control program of the surgical suturingsystem.

Example 10

The surgical suturing system of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9,wherein the needle track comprises a first wall and a second wall,wherein the position sensing system comprises a flex circuit, andwherein the flex circuit comprises a first conductor comprising a firstterminal folded over and adhered to the first wall of the needle trackand a second conductor comprising a second terminal folded over andadhered to the second wall of the needle track, wherein the needle isconfigured to move into and out of contact with the first terminal andthe second terminal as the needle is moved through the firing stroke toindicate the position of the needle.

Example 11

The surgical suturing system of Example 10, wherein the first terminaland the second terminal comprise electrical brushes.

Example 12

A surgical suturing system comprising a needle movable through a firingstroke, wherein the firing stroke comprises a home position, a partiallyfired position, and a fully actuated position, wherein the needle movesalong a path in a single direction from the home position to the fullyactuated position and from the fully actuated position to the homeposition during a full firing stroke. The surgical suturing systemfurther comprises a sensing circuit comprising a supply conductorcomprising a first resistive leg, wherein the first resistive legterminates at a first terminal and comprises a first resistance and areturn conductor comprising a second resistive leg terminating at asecond terminal and comprising a second resistance and a third resistiveleg terminating at a third terminal and comprising a third resistance,wherein the first resistance, the second resistance, and the thirdresistance are different, and wherein the first resistive leg and thesecond resistive leg are wired in parallel with respect to the returnconductor. The needle is movable through the firing stroke to contactthe first terminal, the second terminal, and the third terminal in thehome position of the firing stroke, the second terminal and the thirdterminal in a partially fired position of the firing stroke, and thefirst terminal and the third terminal in a fully fired positon of thefiring stroke. The surgical suturing system further comprises means formonitoring the resistance of the sensing circuit during the firingstroke, wherein the sensing circuit comprises a first circuit resistancewhen the needle is in the home position, a second circuit resistancewhen the needle is in the partially fired position, and a third circuitresistance when the needle is in the fully fired position, wherein thefirst circuit resistance, the second circuit resistance, and the thirdcircuit resistance are different, and wherein the resistance of thesensing circuit indicates the position of the needle during the firingstroke.

Example 13

The surgical suturing system of Example 12, wherein the firing strokecomprises a circular path.

Example 14

The surgical suturing system of Examples 12 or 13, further comprising apower control program configured to determine a rate of advancement ofthe needle based on the monitored resistance.

Example 15

The surgical suturing cartridge of Examples 12, 13, or 14, furthercomprising a power control program configured to automatically adjustcontrol motions applied to the needle based on the monitored resistance.

Example 16

A surgical suturing system comprising a firing system and an endeffector comprising a needle track, an arcuate needle comprisingsuturing material attached thereto, wherein the arcuate needle isconfigured to be guided by the needle track, and wherein the firingsystem is configured to apply control motions to the needle to advancethe arcuate needle through a circular firing stroke to suture tissuewith the suturing material, and a needle detection circuit configured todetect a parameter of the arcuate needle during the circular firingstroke, wherein the surgical suturing system is configured toautomatically adjust the control motions applied to the arcuate needlebased on the detected parameter.

Example 17

The surgical suturing system of Example 16, wherein the needle detectioncircuit comprises an electrical resistance circuit, wherein theelectrical resistance circuit comprises a resistance configured to bealtered by the arcuate needle as the arcuate needle is actuated throughthe circular firing stroke.

Example 18

The surgical suturing system of Examples 16 or 17, wherein the needledetection circuit comprises a plurality of proximity sensors.

Example 19

The surgical suturing system of Examples 16, 17, or 18, wherein theneedle detection circuit comprises a plurality of proximity sensors.

Example 20

The surgical suturing system of Examples 16, 17, 18, or 19, wherein theneedle detection circuit comprises a Hall Effect sensor and a magnet.

Example Set 4 Example 1

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector extending distally fromthe shaft, wherein the end effector comprises a needle track and aneedle comprising suturing material attached thereto, wherein the needleis configured to be guided by the needle track and actuated by thefiring drive through a firing stroke, and wherein the needle is movablealong a needle path comprising a maximum capture width which is greaterthan the shaft diameter.

Example 2

The surgical suturing system of Example 1, wherein the needle isnon-circular.

Example 3

The surgical suturing system of Examples 1 or 2, wherein the needlecomprises a linear segment and an arcuate segment.

Example 4

The surgical suturing system of Examples 1, 2, or 3, wherein the needlecomprises a park position relative to the end effector, wherein thefiring stroke comprises a firing stroke path, and wherein the parkposition is not located on the firing stroke path.

Example 5

The surgical suturing system of Example 4, wherein the surgical suturingsystem is contained with a space defined by the shaft diameter when theneedle is in the park position.

Example 6

The surgical suturing system of Examples 1, 2, 3, 4, or 5, wherein theneedle comprises a linear segment, a proximal arcuate segment, and adistal arcuate segment, wherein the linear segment is disposed betweenthe proximal arcuate segment and the distal arcuate segment.

Example 7

The surgical suturing system of Examples 1, 2, 3, 4, 5, or 6, whereinthe needle track comprises a non-circular path.

Example 8

The surgical suturing system of Examples 1, 2, 3, 4, 5, 6, or 7, whereinthe needle is configured to be actuated in a proximal direction, in adistal direction, and about a rotational axis defined by an end of theneedle.

Example 9

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector extending distally fromthe shaft, wherein the end effector comprises a needle track comprisinga linear section and a needle comprising a linear segment, an arcuatesegment extending from the linear segment, and suturing materialattached to the needle, wherein the needle is configured to be guided bythe needle track and actuated by the firing drive, and wherein thefiring drive is configured to rotate the needle and displace the needlelinearly to move the needle along a continuous loop stroke.

Example 10

The surgical suturing system of Example 9, wherein the needle trackcomprises a y-shaped track.

Example 11

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive and an end effector comprising a flexibleneedle comprising suturing material attached thereto, wherein the firingdrive is configured to apply control motions to the needle to advancethe needle through a firing stroke to suture tissue with the suturingmaterial, and wherein the flexible needle comprises a first end and asecond end, and a movable needle guide, wherein the movable needle guideis movable between a collapsed configuration for passing the endeffector through a trocar, wherein, in the collapsed configuration, theend effector comprises a collapsed diameter which is less than or equalto the shaft diameter, and wherein the first end of the flexible needleis oriented proximal to the second end in the collapsed configuration,and an expanded configuration for suturing tissue with the flexibleneedle, wherein, in the expanded configuration, the end effectorcomprises an expanded diameter which is greater than the shaft diameter,and wherein the flexible is configured to be advanced through its firingstroke when the movable need guide is in the expanded configuration.

Example 12

The surgical suturing system of Example 11, wherein the end effector ishingedly coupled to the shaft such that the end effector can be rotatedrelative to the shaft.

Example 13

The surgical suturing system of Examples 11 or 12, wherein the endeffector further comprises a proximal feed wheel and a distal feed wheelconfigured to be driven by the firing drive, and wherein the flexibleneedle is configured to be fed into and out of the end effector by theproximal feed wheel and the distal feed wheel.

Example 14

The surgical suturing system of Examples 11, 12, or 13, wherein the endeffector further comprises a proximal feed wheel, a distal feed wheel,and an intermediate feed wheel positioned between the proximal feedwheel and the distal feed wheel, wherein the feed wheels are configuredto be driven by the firing drive, wherein the flexible needle isconfigured to be fed into and out of the end effector by the proximalfeed wheel and the distal feed wheel.

Example 15

The surgical suturing system of Examples 11, 12, 13, or 14, wherein themovable needle guide is pivotally coupled to the end effector, andwherein the shaft is coupled to the movable needle guide such that theshaft can pivot the movable needle guide between the collapsedconfiguration and the expanded configuration.

Example 16

A surgical suturing system comprising a shaft comprising a shaftdiameter, a firing drive, and an end effector attached to the shaft,wherein the end effector comprises a needle driver configured to beactuated by the firing drive, a needle track, a needle comprisingsuturing material attached thereto, wherein the needle is configured tobe guided by the needle track and actuated by the needle driver througha firing stroke to suture tissue, and a tissue bite region where theneedle is configured to be advanced through the tissue bite region tosuture tissue, wherein the tissue bite region comprises a width greaterthan the shaft diameter, wherein the end effector is movable relative tothe shaft such that the tissue bite region can extend beyond the shaftdiameter.

Example 17

A surgical suturing system comprising a shaft, a firing drive, and anend effector extending distally from the shaft, wherein the end effectorcomprises a needle track comprising a linear section and a needlecomprising a linear segment, an arcuate segment extending from thelinear segment and suturing material attached to the needle, wherein theneedle is configured to be guided by the needle track and actuated bythe firing drive, wherein the firing drive is configured to rotate theneedle and displace the needle linearly to move the needle throughout aneedle firing stroke, and wherein the needle firing stroke can be variedfrom stroke to stroke.

Example 18

The surgical suturing system of Example 17, wherein the needle comprisesa canoe-like shape.

Example 19

The surgical suturing system of Examples 17 or 18, wherein the needlecomprises a park position relative to the end effector, wherein thefiring stroke comprises a firing stroke path, and wherein the parkposition is not located on the firing stroke path.

Example 20

The surgical suturing system of Example 19, wherein the shaft comprisesa shaft diameter, wherein the surgical suturing system is contained witha space defined by the shaft diameter when the needle is in the parkposition.

Example Set 5 Example 1

A surgical bipolar forceps instrument comprising a shaft comprising afirst electrical pathway and a second electrical pathway and a closablejaw assembly comprising a first jaw comprising a first tissue cuttingblade and a first electrically-conductive portion in electricalcommunication with the first electrical pathway, and a second jawcomprising a second tissue cutting blade and a secondelectrically-conductive portion in electrical communication with thesecond electrical pathway. The surgical bipolar forceps instrumentfurther comprises a pivot, wherein at least one of the first jaw and thesecond jaw are rotatable about the pivot, a drive system comprising anelectric motor operably engaged with at least one of the first jaw andthe second jaw, wherein the drive system is configured to apply amechanical cutting force to the tissue through the rotation of at leastone of the first jaw and the second jaw, a power supply system inelectrical communication with the first electrical pathway and thesecond electrical pathway configured to apply an electrosurgical cuttingforce to the tissue through at least one of the firstelectrically-conductive portion and the second electrically-conductiveportion, and a control system configured to control when the mechanicalcutting force and the electrosurgical cutting force are applied to thetissue.

Example 2

The surgical bipolar forceps instrument of Example 1, wherein thecontrol system is configured to monitor the current drawn by theelectric motor and change the speed of the electric motor to control theclosing speed of the jaw assembly.

Example 3

The surgical bipolar forceps instrument of Examples 1 or 2, wherein thecontrol system comprises a pulse width modulation motor control circuitto change the speed of the electric motor.

Example 4

The surgical bipolar forceps instrument of Examples 1, 2, or 3, whereinthe control system is configured to increase the electrosurgical cuttingforce when the electrical motor slows down.

Example 5

The surgical bipolar forceps instrument of Examples 1, 2, 3, or 4,wherein the control system is configured to increase the electrosurgicalcutting force when the electrical motor is slowed down by the controlsystem.

Example 6

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, or 5,wherein the control system is configured to decrease the electrosurgicalcutting force when the electrical motor speeds up.

Example 7

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, or 6,wherein the control system is configured to increase the electrosurgicalcutting force when the electrical motor is sped up by the controlsystem.

Example 8

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, or7, wherein the control system is configured to initiate theelectrosurgical cutting force when the electrical motor slows down.

Example 9

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,or 8, wherein the control system is configured to initiate theelectrosurgical cutting force when the electrical motor stops.

Example 10

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, or 9, wherein the control system is configured to monitor the currentdrawn by the electric motor and change at least one of the current andthe voltage applied to the tissue through the first and theelectrically-conductive portions.

Example 11

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, or 10, wherein the control system comprises at least one of avoltage regulation circuit and a current regulation circuit configuredto control the electrical power supplied to the tissue.

Example 12

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, or 11, wherein the control system comprises an AC voltagecontrol circuit configured to control the voltage potential applied tothe first and the electrically-conductive portions.

Example 13

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, or 12, wherein the control system comprises a DC voltagecontrol circuit configured to control the voltage potential applied tothe first and the electrically-conductive portions.

Example 14

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, or 13, wherein the control system comprises a currentcontrol circuit configured to control the electrical power applied tothe patient tissue.

Example 15

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, or 14, wherein the control system comprises apulse width modulation motor control circuit to change the speed of theelectric motor.

Example 16

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, or 15, wherein the control system slows theelectric motor when the electrosurgical cutting force increases.

Example 17

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, or 16, wherein the control system slowsthe electric motor when the control system increases the electrosurgicalcutting force.

Example 18

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, or 17, wherein the control systemspeeds up the electric motor when the electrosurgical cutting forcedecreases.

Example 19

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or 18, wherein the control systemspeeds up the electric motor when the control system decreases theelectrosurgical cutting force.

Example 20

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, or 19, wherein the controlsystem stops the electric motor when the electrosurgical cutting forceincreases.

Example 21

The surgical bipolar forceps instrument of Examples 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20, wherein the controlsystem stops the electric motor when the control system increases theelectrosurgical cutting force

Example 22

A surgical instrument comprising a shaft comprising an electricalpathway and a closable jaw assembly comprising a first jaw comprising atissue cutting blade and an electrode in electrical communication withthe electrical pathway. The closable jaw assembly further comprises asecond jaw. The surgical instrument further comprises a pivot, whereinthe first jaw is rotatable about the pivot, a drive system comprising anelectric motor operably engaged with the first jaw, wherein the drivesystem is configured to apply a mechanical cutting force to the tissuethrough the rotation of the first jaw, a power supply system inelectrical communication with the electrical pathway configured to applyan electrosurgical cutting force to the tissue through the electrode,and a control system configured to control when the mechanical cuttingforce and the electrosurgical cutting force are applied to the tissue.

Example 23

A surgical instrument comprising a shaft comprising an electricalpathway and a closable jaw assembly comprising a first jaw comprising atissue cutting blade and a second jaw comprising an electrode inelectrical communication with the electrical pathway. The surgicalinstrument further comprises a pivot, wherein at least one of the firstjaw is rotatable about the pivot, a drive system comprising an electricmotor operably engaged with the closable jaw assembly, wherein the drivesystem is configured to apply a mechanical cutting force to the tissuethrough the rotation of at least one of the first jaw and the secondjaw, a power supply system in electrical communication with theelectrical pathway configured to apply an electrosurgical cutting forceto the tissue through the electrode, and a control system configured tocontrol when the mechanical cutting force and the electrosurgicalcutting force are applied to the tissue.

Example 24

A surgical bipolar forceps instrument comprising a shaft comprising afirst electrical pathway and a second electrical pathway and a first jawcomprising a first tissue cutting blade and a firstelectrically-conductive portion in electrical communication with thefirst electrical pathway. The surgical bipolar forceps instrumentfurther comprises a second jaw comprising a second tissue cutting bladeand a second electrically-conductive portion in electrical communicationwith the second electrical pathway. The surgical bipolar forcepsinstrument further comprises a pivot, wherein at least one of the firstjaw and the second jaw are rotatable about the pivot and means fortreating the tissue of a patient comprising means for applying amechanical cutting force to the tissue through the rotation of at leastone of the first jaw member and the second jaw member and means forapplying electrosurgical force to the tissue through at least one of thefirst electrically-conductive portion and the secondelectrically-conductive portion.

Example Set 6 Example 1

A modular surgical instrument comprising a control interface, a shaftextending from said control interface, an end effector extending fromsaid shaft, and a control circuit configured to sense the electricalpotential applied to said modular surgical instrument, determine if saidsensed electrical potential is above a predetermined threshold, andadjust the operation of said modular surgical instrument when saidsensed electrical potential exceeds said predetermined threshold.

Example 2

The modular surgical instrument of Example 1, further comprising anarticulation joint, wherein said end effector is configured to bearticulated relative to said shaft by said control interface, andwherein said control circuit is configured to unarticulate said endeffector when said sensed electrical potential exceeds saidpredetermined threshold and said end effector is in an articulatedstate.

Example 3

The modular surgical instrument of Example 2, wherein said controlcircuit is configured to unarticulate said end effector to anunarticulated state.

Example 4

The modular surgical instrument of Examples 2 or 3, wherein said controlcircuit is configured to unarticulate said end effector until saidsensed electrical potential falls below said predetermined threshold.

Example 5

The modular surgical instrument of Examples 1, 2, 3, or 4, wherein saidcontrol circuit is configured to carry out an operation adjustment untilsaid sensed electrical potential falls below said predeterminedthreshold.

Example 6

The modular surgical instrument of Examples 1, 2, 3, 4, or 5, whereinsaid control circuit is configured to carry out an operation adjustmentuntil a predetermined period of time passes after said sensed electricalpotential falls below said predetermined threshold.

Example 7

A surgical suturing system comprising an actuation interface comprisinga motor, an attachment interface, and an output drive configured to bedriven by said motor. The surgical suturing system further comprises amodular attachment configured to be attached to and detached from saidactuation interface, wherein said modular attachment comprises a shaft,an input drive configured to be coupled with said output drive upon theattachment of said modular attachment and said actuation interface, andan end effector extending distally from said shaft. The surgicalsuturing system further comprises a load sensor configured to detect theload applied to said input drive and said output drive when said inputdrive and said output drive are actuated by said motor, wherein saidsurgical suturing system further comprises a control circuit configuredto monitor said detected load from said load sensor, limit current flowthrough said motor when said detected load reaches a first threshold,and stop power to said motor when said detected load reaches a secondthreshold.

Example 8

The surgical suturing system of Example 7, wherein said second thresholdis less than said first threshold.

Example 9

The surgical suturing system of Example 7, wherein said second thresholdis greater than said first threshold.

Example 10

A surgical instrument comprising a motor, a drive system configured tobe actuated by said motor, a shaft, an articulation joint, an endeffector attached to said shaft by way of said articulation joint,wherein said end effector is configured to be articulated relative tosaid shaft by said drive system, and a control circuit configured todetect electrical energy applied to said surgical instrument; and alterthe actuation of said motor when an unexpected electrical energy isdetected.

Example 11

The surgical instrument of Example 10, wherein said control circuit isconfigured to reverse the actuation of said motor when an unexpectedelectrical energy is detected.

Example 12

The surgical instrument of Examples 10 or 11, wherein said controlcircuit is configured to pause the actuation of said motor when anunexpected electrical energy is detected.

Example 13

The surgical instrument of Examples 10, 11, or 12, wherein said controlcircuit is further configured to indicate to a user the condition ofsaid surgical instrument when an unexpected electrical energy isdetected.

Example 14

A surgical suturing system comprising a first motor, a second motor, ashaft, an end effector attached to said shaft, wherein said end effectorcomprises a longitudinal axis, wherein said second motor is configuredto rotate said end effector about said longitudinal axis, a needleconfigured to be driven through a firing stroke by said first motor andsuturing material attached to said needle. The surgical suturing systemfurther comprises a first sensor configured to sense force experiencedby said needle as said needle is advanced through said firing stroke, asecond sensor configured to sense load torque experienced by said endeffector as said end effector is rotated about said longitudinal axis, athird sensor configured to sense bending load experienced by said shaft,and a control program configured to monitor said force experienced bysaid needle such that, if said force experienced by said needle exceedsa first predetermined threshold, said control program limits the currentflow through said first motor, monitor said load torque experienced bysaid end effector such that, if said load torque experienced by said endeffector exceeds a second predetermined threshold, said control programlimits the current flow through said second motor, and monitor saidbending load experienced by said shaft such that, if said load bendingload experienced by said shaft exceeds a third predetermined threshold,said control program reduces the current flow through said second motor.

Example 15

The surgical suturing system of Example 14, wherein said first sensorcomprises a strain gauge.

Example 16

The surgical suturing system of Examples 14 or 15, wherein said secondsensor comprises a strain gauge.

Example 17

The surgical suturing system of Examples 14, 15, or 16, wherein saidthird sensor comprises a strain gauge.

Example 18

The surgical suturing system of Examples 14, 15, 16, or 17, wherein datameasured by said first sensor, said second sensor, and said third sensorare indicated to a user of said surgical suturing system.

Example 19

The surgical suturing system of Examples 14, 15, 16, 17, or 18, furthercomprising a surgical suturing cartridge.

The surgical instrument systems described herein are motivated by anelectric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In certain instances,the motors disclosed herein may comprise a portion or portions of arobotically controlled system. U.S. patent application Ser. No.13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example,discloses several examples of a robotic surgical instrument system ingreater detail, the entire disclosure of which is incorporated byreference herein.

The devices, systems, and methods disclosed in the Subject Applicationcan be used with the devices, systems, and methods disclosed in U.S.patent application Ser. No. 13/832,786, now U.S. Pat. No. 9,398,905,entitled CIRCULAR NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS;U.S. patent application Ser. No. 14/721,244, now U.S. Patent ApplicationPublication No. 2016/0345958, entitled SURGICAL NEEDLE WITH RECESSEDFEATURES; and U.S. patent application Ser. No. 14/740,724, now U.S.Patent Application Publication No. 2016/0367243, entitled SUTURINGINSTRUMENT WITH MOTORIZED NEEDLE DRIVE, which are incorporated byreference in their entireties herein.

The devices, systems, and methods disclosed in the Subject Applicationcan also be used with the devices, systems, and methods disclosed inU.S. Provisional Patent Application No. 62/659,900, entitled METHOD OFHUB COMMUNICATION, filed on Apr. 19, 2018, U.S. Provisional PatentApplication No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM,filed on Dec. 28, 2017, U.S. Provisional Patent Application No.62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on Dec. 28,2017, and U.S. Provisional Patent Application No. 62/611,339, entitledROBOT ASSISTED SURGICAL PLATFORM, filed on Dec. 28, 2017, which areincorporated by reference in their entireties herein.

The devices, systems, and methods disclosed in the Subject Applicationcan also be used with the devices, systems, and methods disclosed inU.S. patent application Ser. No. 15/908,021, entitled SURGICALINSTRUMENT WITH REMOTE RELEASE, filed on Feb. 28, 2018, U.S. patentapplication Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVINGDUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTORMOVEMENT, filed on Feb. 28, 2018, U.S. patent application Ser. No.15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S.patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,058,entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed on Feb.28, 2018, and U.S. patent application Ser. No. 15/908,143, entitledSURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed on Feb.28, 2018, which are incorporated in their entireties herein.

The surgical instrument systems described herein are motivated by anelectric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In certain instances,the motors disclosed herein may comprise a portion or portions of arobotically controlled system. U.S. patent application Ser. No.13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example,discloses several examples of a robotic surgical instrument system ingreater detail, the entire disclosure of which is incorporated byreference herein.

The surgical instrument systems described herein can be used inconnection with the deployment of suture material to seal tissue.Moreover, various embodiments are envisioned which utilize any suitablemeans for sealing tissue. For instance, an end effector in accordancewith various embodiments can comprise electrodes configured to heat andseal the tissue. Also, for instance, an end effector in accordance withcertain embodiments can apply vibrational energy to seal the tissue. Inaddition, various embodiments are envisioned which utilize a suitablecutting means to cut the tissue.

The entire disclosures of:

-   -   U.S. patent application Ser. No. 11/013,924, entitled TROCAR        SEAL ASSEMBLY, now U.S. Pat. No. 7,371,227;    -   U.S. patent application Ser. No. 11/162,991, entitled        ELECTROACTIVE POLYMER-BASED ARTICULATION MECHANISM FOR GRASPER,        now U.S. Pat. No. 7,862,579;    -   U.S. patent application Ser. No. 12/364,256, entitled SURGICAL        DISSECTOR, now U.S. Patent Application Publication No.        2010/0198248;    -   U.S. patent application Ser. No. 13/536,386, entitled EMPTY CLIP        CARTRIDGE LOCKOUT, now U.S. Pat. No. 9,282,974;    -   U.S. patent application Ser. No. 13/832,786, entitled CIRCULAR        NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS, now U.S.        Pat. No. 9,398,905;    -   U.S. patent application Ser. No. 12/592,174, entitled APPARATUS        AND METHOD FOR MINIMALLY INVASIVE SUTURING, now U.S. Pat. No.        8,123,764;    -   U.S. patent application Ser. No. 12/482,049, entitled ENDOSCOPIC        STITCHING DEVICES, now U.S. Pat. No. 8,628,545;    -   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL        STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT        ARRANGEMENTS, now U.S. Pat. No. 9,072,535;    -   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL        INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.        7,845,537;    -   U.S. patent application Ser. No. 14/200,111, entitled CONTROL        SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629;    -   U.S. patent application Ser. No. 14/248,590, entitled MOTOR        DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now        U.S. Pat. No. 9,826,976;    -   U.S. patent application Ser. No. 14/813,242, entitled SURGICAL        INSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIAL        OPERATION OF THE SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2017/0027571;    -   U.S. patent application Ser. No. 14/248,587, entitled POWERED        SURGICAL STAPLER, now U.S. Pat. No. 9,867,612;    -   U.S. patent application Ser. No. 12/945,748, entitled SURGICAL        TOOL WITH A TWO DEGREE OF FREEDOM WRIST, now U.S. Pat. No.        8,852,174;    -   U.S. patent application Ser. No. 13/297,158, entitled METHOD FOR        PASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTE ACTUATOR INTO AN        INDEPENDENTLY ROTATING MEMBER, now U.S. Pat. No. 9,095,362;    -   International Application No. PCT/US2015/023636, entitled        SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION, now        International Patent Publication No. WO 2015/153642 A1;    -   International Application No. PCT/US2015/051837, entitled        HANDHELD ELECTROMECHANICAL SURGICAL SYSTEM, now International        Patent Publication No. WO 2016/057225 A1;    -   U.S. patent application Ser. No. 14/657,876, entitled SURGICAL        GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, U.S.        Patent Application Publication No. 2015/0182277;    -   U.S. patent application Ser. No. 15/382,515, entitled MODULAR        BATTERY POWERED HANDHELD SURGICAL INSTRUMENT AND METHODS        THEREFOR, U.S. Patent Application Publication No. 2017/0202605;    -   U.S. patent application Ser. No. 14/683,358, entitled SURGICAL        GENERATOR SYSTEMS AND RELATED METHODS, U.S. Patent Application        Publication No. 2016/0296271;    -   U.S. patent application Ser. No. 14/149,294, entitled HARVESTING        ENERGY FROM A SURGICAL GENERATOR, U.S. Pat. No. 9,795,436;    -   U.S. patent application Ser. No. 15/265,293, entitled TECHNIQUES        FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, U.S. Patent        Application Publication No. 2017/0086910; and    -   U.S. patent application Ser. No. 15/265,279, entitled TECHNIQUES        FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL        SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, U.S. Patent        Application Publication No. 2017/0086914, are hereby        incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one or moreother embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdo not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical suturing system, comprising: a shaft;a firing drive; an end effector extending distally from said shaft,wherein said end effector comprises: a needle driver, wherein saidfiring drive is configured to apply control motions to said needledriver; a needle track; and a needle comprising suturing materialattached thereto, wherein said needle is configured to be guided by saidneedle track and actuated by said needle driver through a continuousfiring stroke to suture tissue, wherein said continuous firing strokecomprises a starting position, and wherein said continuous firing strokecomprises an anticipated distance defined by said starting positionwhich said needle moves to complete said continuous firing stroke; and aposition sensing circuit comprising a detectable parameter, wherein saidneedle is configured to vary the detectable parameter of saidpositioning sensing circuit as said needle is advanced through saidcontinuous firing stroke, wherein said surgical suturing system isconfigured to: monitor the detectable parameter of said position sensingcircuit to determine if said needle has traveled said anticipateddistance; and automatically adjust said control motions applied to saidneedle driver based on the determination of whether or not said needlehas traveled said anticipated distance to position said needle in saidstarting position before each subsequent continuous firing stroke upondetermining that said needle has not traveled said anticipated distance.2. The surgical suturing system of claim 1, wherein said positionsensing circuit comprises: an infrared LED emitter; and a photodetectorconfigured to detect infrared light emitted by said infrared LEDemitter, wherein said needle is configured to interrupt the infraredlight emitted by said infrared LED emitter as said needle is movedthrough said continuous firing stroke to indicate the position of saidneedle.
 3. The surgical suturing system of claim 2, wherein said needletrack comprises an exit location where said needle exits said needletrack and an entry location where said needle reenters said needletrack, and wherein said infrared LED emitter is positioned at said exitlocation.
 4. The surgical suturing system of claim 1, wherein thedetectable parameter comprises a load experienced by said needle duringsaid continuous firing stroke.
 5. The surgical suturing system of claim4, wherein said surgical suturing system is configured to adjust saidcontrol motions when said load exceeds a predetermined threshold.
 6. Thesurgical suturing system of claim 1, wherein said position sensingcircuit comprises a plurality of proximity sensors configured to detectthe position of said needle as said needle is advanced through saidcontinuous firing stroke.
 7. The surgical suturing system of claim 6,wherein said plurality of proximity sensors are positioned such thatsaid needle is configured to trip at least two of said plurality ofproximity sensors at all times during said continuous firing stroke, andwherein said surgical suturing system is configured to determine if saidneedle has diverted from said needle track if less than two of saidproximity sensors are tripped at any point during said continuous firingstroke.
 8. The surgical suturing system of claim 1, wherein saidposition sensing circuit comprises: a magnet; and a Hall Effect sensor,wherein said needle is configured to interrupt a magnetic field inducedby said magnet to change the condition of said Hall Effect sensor toindicate the position of said needle driver to a control program of thesurgical suturing system.
 9. The surgical suturing system of claim 1,wherein said position sensing circuit comprises a proximity sensorconfigured to sense movement of said needle driver as said needle driveradvances said needle through said continuous firing stroke to indicatethe position of said needle driver to a control program of the surgicalsuturing system.
 10. The surgical suturing system of claim 1, whereinsaid needle track comprises a first wall and a second wall, wherein saidposition sensing circuit comprises a flex circuit, and wherein said flexcircuit comprises: a first conductor comprising a first terminal foldedover and adhered to said first wall of said needle track; and a secondconductor comprising a second terminal folded over and adhered to saidsecond wall of said needle track, wherein said needle is configured tomove into and out of contact with said first terminal and said secondterminal as said needle is moved through said continuous firing stroketo indicate the position of said needle.
 11. The surgical suturingsystem of claim 10, wherein said first terminal and said second terminalcomprise electrical brushes.
 12. A surgical suturing system, comprising:a needle movable through a firing stroke, wherein said firing strokecomprises: a home position; a partially fired position; and a fullyactuated position, wherein said needle moves along a path in a singledirection from said home position to said fully actuated position andfrom said fully actuated position to said home position during a fullfiring stroke; a sensing circuit, comprising: a supply conductorcomprising a first resistive leg, wherein said first resistive legterminates at a first terminal and comprises a first resistance; and areturn conductor, comprising: a second resistive leg terminating at asecond terminal and comprising a second resistance; and a thirdresistive leg terminating at a third terminal and comprising a thirdresistance, wherein said first resistance, said second resistance, andsaid third resistance are different, and wherein said first resistiveleg and said second resistive leg are wired in parallel with respect tosaid return conductor, wherein said needle is movable through saidfiring stroke to contact: said first terminal, said second terminal, andsaid third terminal in said home position of said firing stroke; saidsecond terminal and said third terminal in said partially fired positionof said firing stroke; and said first terminal and said third terminalin said fully actuated position of said firing stroke; and means formonitoring the resistance of said sensing circuit during said firingstroke, wherein said sensing circuit comprises a first circuitresistance when said needle is in said home position, a second circuitresistance when said needle is in said partially fired position, and athird circuit resistance when said needle is in said fully firedposition, wherein said first circuit resistance, said second circuitresistance, and said third circuit resistance are different, and whereinthe resistance of said sensing circuit indicates the position of saidneedle during said firing stroke.
 13. The surgical suturing system ofclaim 12, wherein said firing stroke comprises a circular path.
 14. Thesurgical suturing system of claim 12, further comprising a power controlprogram configured to determine a rate of advancement of said needlebased on the monitored resistance.
 15. The surgical suturing system ofclaim 12, further comprising a power control program configured toautomatically adjust control motions applied to said needle based on themonitored resistance.
 16. A surgical suturing system, comprising: afiring system; and an end effector, comprising: a needle track; anarcuate needle comprising suturing material attached thereto, whereinsaid arcuate needle is configured to be guided by said needle track,wherein said firing system is configured to apply control motions tosaid needle to advance said arcuate needle through a circular firingstroke to suture tissue with said suturing material, wherein saidcircular firing stroke comprises a starting position, and wherein saidcircular firing stroke comprises an anticipated distance defined by saidstarting position which said arcuate needle moves to complete saidcircular firing stroke; and a needle detection circuit configured todetect a parameter of said arcuate needle during said circular firingstroke, wherein said surgical suturing system is configured to:determine if said arcuate needle has traveled said anticipated distance;and automatically adjust said control motions applied to said arcuateneedle based on the determination of whether or not said arcuate needlehas traveled said anticipated distance to position said arcuate needlein said starting position before each subsequent circular firing strokeupon determining that said arcuate needle has not traveled saidanticipated distance.
 17. The surgical suturing system of claim 16,wherein said needle detection circuit comprises an electrical resistancecircuit, wherein said electrical resistance circuit comprises aresistance configured to be altered by said arcuate needle as saidarcuate needle is actuated through said circular firing stroke.
 18. Thesurgical suturing system of claim 16, wherein said needle detectioncircuit comprises a plurality of proximity sensors.
 19. The surgicalsuturing system of claim 16, wherein said needle detection circuitcomprises a Hall Effect sensor and a magnet.